塞来昔布作为布洛芬在扁桃体切除术后疼痛和出血控制方面的非劣效替代方案。
Celecoxib as a non-inferior alternative to ibuprofen in post-tonsillectomy pain and bleeding control.
文献信息
| PMID | 42868944 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Lexy Maulsby |
| 作者单位 | University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL, 32827, USA. Electronic address: lexymaulsby@ucf.edu. |
| 期刊 | International journal of pediatric otorhinolaryngology |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
引言： 扁桃体切除术后疼痛是该手术的主要并发症，导致经口摄入不良、脱水和出血。布洛芬是一种非选择性环氧化酶（COX）抑制剂，常用于术后镇痛，但表现出强效的血小板抑制作用。塞来昔布是一种选择性COX-2抑制剂，在提供抗炎和镇痛作用的同时保留血小板功能。儿科使用仍然有限。
目的： 评估塞来昔布在儿科扁桃体切除术患者中关于疼痛、脱水和出血的术后结局与布洛芬相当。
方法： 一项经IRB批准的回顾性队列研究，纳入2024年1月1日至12月31日期间进行的扁桃体切除术并接受布洛芬或塞来昔布治疗的患者。使用CPT®代码42820、42821、42825和42826识别接受扁桃体切除术的≤18岁患者。排除标准包括既往扁桃体手术、除腺样体切除术外的伴随手术、出血性疾病以及阿片类药物或替代NSAID使用。患者按术后即刻镇痛方案分组：塞来昔布或布洛芬。结局包括术后疼痛、脱水、出血和因出血再次手术。
结果： 共纳入1144例患者（塞来昔布N=157，布洛芬N=987）。塞来昔布组总体并发症率为3.2%，布洛芬组为7.1%。在疼痛（RR，0.27；95% CI，0.04-2.01）、脱水（RR，1.72；95% CI，0.48-6.08）、出血（RR，0.30；95% CI，0.07-1.22）或返回手术室（RR，0.35；95% CI，0.05-2.60）方面未观察到统计学显著差异。
结论： 塞来昔布表现出与布洛芬相当的术后安全性结局。一些家长注意到了实际益处。它可能代表一种安全的非阿片类药物替代方案，用于儿科扁桃体切除术后疼痛管理。
英文摘要
INTRODUCTION: Post-tonsillectomy pain represents the major morbidity of the procedure, contributing to poor oral intake, dehydration, and hemorrhage. Ibuprofen, a non-selective cyclooxygenase (COX) inhibitor, is commonly used for post-operative analgesia but demonstrates potent platelet inhibition. Celecoxib, a selective COX-2 inhibitor, preserves platelet function while providing anti-inflammatory and analgesic effects. Pediatric use remains limited.
OBJECTIVES: To evaluate celecoxib postoperative outcomes as comparable to ibuprofen regarding pain, dehydration, and hemorrhage in pediatric tonsillectomy patients.
METHODS: An IRB-approved retrospective cohort study of tonsillectomies performed between January 1 to December 31, 2024 and treated with ibuprofen or celecoxib. Patients ≤18 years old who underwent tonsillectomy were identified using CPT® codes 42820, 42821, 42825, and 42826. Exclusion criteria included prior tonsillar surgery, concomitant procedures other than adenoidectomy, bleeding disorders, and opioid or alternative NSAID use. Patients were grouped by immediate post-operative analgesic regimen: celecoxib or ibuprofen. Outcomes included postoperative pain, dehydration, hemorrhage, and reoperation for bleeding.
RESULTS: A total of 1144 patients were included (celecoxib N = 157, ibuprofen N = 987). Overall complication rates were 3.2% in the celecoxib group and 7.1% in the ibuprofen group. No statistically significant differences were observed in pain (RR, 0.27; 95% CI, 0.04-2.01), dehydration (RR, 1.72; 95% CI, 0.48-6.08), hemorrhage (RR, 0.30; 95% CI, 0.07-1.22), or return to the operating room (RR, 0.35; 95% CI, 0.05-2.60).
CONCLUSION: Celecoxib demonstrated post-operative safety outcomes comparable to ibuprofen. Some parents noted practical benefits. It may represent a safe non-opioid alternative for pediatric tonsillectomy pain management.