A comparison of analgesic effect between loxoprofen and celecoxib and the frequency of the hemorrhage following tonsillectomy

Abstract

Hemorrhage following tonsillectomy is still a major complication despite the progress in medical technology. Celecoxib is a selective COX-2 inhibitor and has a lower effect of platelet aggregation compared with conventional nonsteroidal anti-inflammatory drugs (NSAIDs). We investigated whether or not the selection of celecoxib would reduce the risk of hemorrhage and provide a good analgesic effect following tonsillectomy in comparison with the use of loxoprofen (a conventional NSAID). We divided 107 cases of tonsillectomy into two groups by the kind of analgesic prescribed; the celecoxib group (n = 55) and the loxoprofen group (n = 52). Regarding the effective rate of the analgesic effect, the loxoprofen group scored 93.3% and the celecoxib group scored 68.6%. There was a significant difference between them (p = 0.0003). Regarding side effects, the celecoxib group showed no side effects, whereas 8.0% of the loxoprofen group developed abdominal pain. There were no statistically significant differences between the changes in the VAS scale regarding the pain (p = 0.834), the prescription periods of analgesic (p = 0.485), the amount of food intake during the hospitalization (p = 0.579), the rescue dosage rate (p = 0.585), periods of usage (p = 0.198) and the last dosage day. As for the tendency and the grade of postoperative hemorrhage, there were no statistically differences between the two groups (p = 0.220). The rates of occurrence of late-onset hemorrhage (i.e. after the postoperative eleventh day) were 0.0% (0/11) in the the celecoxib group (n = 11) and 31.2% (5/16) in the the loxoprofen group showing a statistically differences between them (p = 0.049). Our results suggest that Celecoxib might reduce the risk of late-onset hemorrhage after the postoperative eleventh day with few side effects, so it could be a useful analgesic drug following tonsillectomy. However, it might be necessary to consider administration in combination with acetaminophen because Celecoxib has insufficient analgesic effect following tonsillectomy.