Effect of Rofecoxib on Pain and Hemorrhage after Tonsillectomy

Lee, Seung Kyun; Hwang, Sung Jae; Park, Yong Soo; Kim, Myung Won; Kim, Kyu Baek; Cho, Jung Hae; Jeon, Eun ju

Abstract

BACKGROUND AND OBJECTIVES
Nonsteroidal anti-inflammatory durgs (NSAIDs) are now widely accepted analgesics for posttonsillectomy patients, but their ability to inhibit platelet cyclooxygenase (COX) may be associated with a risk of increased bleeding after tonsillectomy. Rofecoxib, the recently introduced selective COX-2 inhibitor, may have advantages for analgesics in tonsillectomy in that they produce minimal effects on platelet aggregation. But the analgesic efficacy of rofecoxib in tonsillectomy has not been made known yet. The aim of our randomized prospective study was to compare the analgesic efficacy of rofecoxib, the selective COX-2 inhibitor, and ibuprofen, the classic NSAID, for the posttonsillectomy pain management. We also evaluated the influence of both drugs on the posttonsillectomy bleeding. SUBJECTS AND METHOD: Thirty-eight adult patients undergoing tonsillectomy were randomly divided into either ibuprofen or rofecoxib group. Patients received either oral ibuprofen (600 mg, three times a day) or oral rofecoxib (25 mg, twice a day). Patients recorded pain levels twice daily for 7 days using a visual analogue scale. Posttonsillectomy hemorrhage was recorded in each groups. RESULTS: Pain scores for the 7 days were not significantly different between two groups, but the rofecoxib group reported less pain. Rofecoxib group felt more satisfactorily about early control of postoperative pain. There was no significant difference in the incidence of postoperative hemorrhage between two groups. CONCLUSION: Rofecoxib is as effective as ibuprofen for postoperative pain control in adult tonsillectomy, which might be beneficial for avoiding the adverse effects of NSAIDs.