The effect of intra-operative Parecoxib in tonsillectomy and post-operative bleeding at Toowoomba Hospital

<p>Christopher Jackson</p>

The effect of intra-operative Parecoxib in tonsillectomy and post-operative bleeding at Toowoomba Hospital

Christopher Jackson

Toowoomba Base Hospital, Australia

: J Otol Rhinol

Abstract

Background & Aims: Tonsillectomy is a common procedure performed by otolaryngologists. There appears to be significant variation in analgesic practices between hospitals and surgeons and some of this variation likely stems from considerations regarding post-operative bleeding risk, particularly with respect to Non-Steroidal Anti-Inflammatory Drugs (NSAID). Previous studies have demonstrated peri-operative parecoxib administration to be associated with less acute pain than standard treatments. The aim of this study was to determine whether the use of intra-operative selective cyclooxygenase-2 (COX-2) inhibitors was associated with an increase in post-tonsillectomy bleeding (PTB) rates at our institution. Methodology: Retrospective data were collected from patients at Toowoomba Hospital who underwent tonsillectomy from January 2016 until November 2017. Patient data including demographics, operation type and whether or not intra-operative Parecoxib was given to the patient was collected. Re-admission rates due to any PTB and return to theatre rates for each group were compiled and analyzed. Results: There were 574 patients who underwent tonsillectomy during the 20 months included in this study. 168 patients (29.3%) received a single dose of intravenous Parecoxib intra-operatively. The total re-admission rate for this period was 6.8% (N=39) with a return to theatre rate of 2.3% (N=13). For the patients that did not receive Parecoxib the re-admission rate was 6.2% with a return to theatre rate of 2.2%. For the patients who received Parecoxib the re-admission rate was 9.5% and 2.4% required return to theatre. Comparing those that had Parecoxib and those that did not there was a statistically significant (P<0.05) difference in re-admission rate but not in return to theatre rate.