So I was talking with my anesthesiologist during surgery the other day, and we were
discussing postoperative pain control options (yes, I know we have scintillating discussions in the OR). He keeps hoping we will employ more Celecoxib, aka “Celebrex”. He has read a bunch about it in the anesthesia literature, so he brought me in some of the articles.
This is one for the archives, printed in the Aesthetic Plastic Surgical Journal in 2005. “The Use of Celecoxib for Reduction of Pain After Subpectoral Breast Augmentation.”
What is Celebrex?
It is a COX-2 inhibitor like other non steroidal (NSAID) medications. NSAIDs block things in your body which lead to the first phase of inflammation and the resulting pain. Traditional NSAIDS block COX 1 and COX 2. Celebrex was developed to be more specific, so it only blocks COX2. It is thought this causes less side effects.
Study:
- 400 mg dose was give orally 30 minutes before surgery.
- Subpectoral (under the muscle) breast augmentations hurt, so a good surgery to pick.
- 695 patients were treated, and got placebo or treatment randomly
Findings?
- Significantly fewer opioid pain medications were used after surgery. (statistically significant).
- Interestingly it was also seen that nonsmokers and women with many kids required significantly lower opioid pain medication than smokers/no kids.
My thoughts?
Nowhere in the article does it discuss bleeding and bruising, which are my usual questions when talking about NSAIDs. I have seen issues with bleeds in breast surgery following Toradol (and injectable NSAID), which is why I do not use Toradol.
Interesting stuff. I will keep researching.