Postoperative analgesic effect of parecoxib sodium local anesthesia in patients with breast cancer through systematic review and meta-analysis

Abstract

Background: Postoperative pain can seriously affect a patient’s recovery, and parecoxib sodium has a good analgesic effect. However, there is a lack of clinically systematic analyses of the effects of parecoxib sodium on postoperative pain in breast cancer patients. The aim of the present study was to systematically evaluate the efficacy and safety of parecoxib sodium local anesthesia in the treatment of postoperative pain in breast cancer patients. Methods: Literature published from January 2010 to December 2020 was searched in the China National Knowledge Infrastructure database, Wanfang database, PubMed, and Cochrane Library. Literature on randomized controlled trials of parecoxib sodium local anesthesia in patients with breast cancer was collected. Method of treatment was extracted and literature quality was assessed. Meta-analyses of included literature were performed using RevMan 5.3. Results: A total of 17 randomized controlled trials were included, with a total of 1,032 breast cancer surgery patients. The experimental group was treated with parecoxib sodium anesthesia, and the control group was treated with other anesthesia methods. The meta-analysis results showed that there were obvious differences among visual analogue scale (VAS) score of the experimental group and control group 2 h after surgery [mean difference (MD): –0.79; 95% confidence interval (CI): –1.29 to –0.29; P=0.002], 4 h (MD =–0.77; 95% CI: =–1.51 to –0.03; P=0.04), 6 h (MD: –1.10; 95% CI: –1.41 to –0.80; P<0.00001), 8 h (MD: –0.66; 95% CI: –1.00 to –0.33; P=0.0001), 12 h (MD: –0.92; 95% CI: –1.24 to –0.60; P<0.00001), 24 h (MD: –0.86; 95% CI: –1.15 to –0.58; P<0.00001), and 48 h (MD: –0.90; 95% CI: –1.47 to –0.33; P=0.002). Moreover, visual analog scale score and the postoperative controlled analgesia frequency of patients in the experimental group (MD: –2.08; 95% CI: –2.88 to –1.27; P<0.00001) and the incidence of adverse reactions (odds ratio: 0.52; 95% CI: 0.34–0.80; P=0.002) were significantly reduced. Discussion: Parecoxib sodium local anesthesia for breast cancer patients has good postoperative analgesia and treatment safety.