OBJECTIVETo investigate the postoperative analgesic effect of parecoxib sodium in patients with posterior spinal surgery.

METHODSEighty patients undergoing posterior spinal surgery under general anesthesia were randomly divided into parecoxib sodium group and placebo group (n=40). All the patients received a single dose of m ml morphine (1.0 mg/ml) as the background analgesia immediately after the operation. The patients in parecoxib sodium group were given 40 mg parecoxib sodium intravenously, and those in the placebo group received an equivalent volume of saline instead, and at 24 and 48 h after the operation, the same dose was repeated. The visual analog pain score, patient satisfaction and adverse reactions were recorded after the administrations.

RESULTSCompared with the placebo group, the patients in parecoxib sodium group had significantly lowered VAS score at 6, 12, 24, and 48 h after the operation (P<0.05). No significant differences were noted in the patient satisfaction and adverse reactions between the two groups.

CONCLUSIONPostoperative short-term use of parecoxib sodium can can provide good postoperative analgesic effect in patients undergoing posterior spinal surgery.

Analgesics, Non-Narcotic ; therapeutic use ; Anesthesia, General ; Cyclooxygenase 2 Inhibitors ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; Isoxazoles ; administration & dosage ; therapeutic use ; Male ; Pain, Postoperative ; drug therapy ; Spinal Diseases ; surgery

Cancer pain patients have various diagnosis, stage of disease, response to pain, and treatments and individualized treatment methods are thus needed. Use of Nonopioid analgesics is the first step treatment (according to WHO ladder) for mild to moderate pain, and may be useful for second or third step treatments when combined with weak or strong opioids to reduce side effects of opioids and to create synergy between the two drugs. Acetaminophen and nonsteroidal antiinflammatory drugs(NSAIDs) are also nonopioid analgesics. NSAIDs have a ceiling effect, along with antipyretic, analgesic and antiinflammatory effects, while not producing physical and psychological dependence. Adverse effects of NSAIDs include gastrointestinal hemorrhage, coagulopathy, and deterioration of renal function.
Acetaminophen ; Analgesics ; Analgesics, Non-Narcotic ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Gastrointestinal Hemorrhage ; Humans ; Resin Cements

A survey on PPA-containing products consumption was conducted in 10 pharmacies located in Hanoi from February to May 2002. It revealed that there were 20 such products available in the market(of them, 16 were domestic). The PPA content as base form in a single dose of all these preparations was not exceeded 25mg. During the studied period, out of 250 people buying medication for cough and cold, 74 people (29.6% bought PPA-containing products with the most purchased ones were Decolgen forte and Rhumenol. Many patients with cough and cold consumed relatively high amount of PPA, not being aware of its adverse effects and contraindications
Pharmacy ; Analgesics, Non-Narcotic ; utilization ; Drugs, Investigational

An HPLC method for simultaneous determination of Dextromethorphan hydrobromide, Clorpheniramine maleate, Guaiphenesin, and Phenylpropanolamine hydrochloride in tablets, capsules or in syrups is introduced. The chromatographic conditions are as follows: Column: Lichrosorb Si 60(250X 4 mm; 5mm); Mobile phase: Water: 0.001 M Ammonium Perchlorate methanolic solution pH6.7:20:80; Flow rate: 0.8 ml/min; UV- Detector at 254 nm. Experimental results showed that the method is accurate (er = 0.69 - 3.19%; recoveries: 98.7-101.9%).
Pharmaceutical Preparations ; Dextromethorphan ; Chlorpheniramine ; Analgesics, Non-Narcotic ; Analgesics

CoX-2 or prostaglandin GH synthetase-2 is an enzyme which has induction, especially in the inflamatory reactions. The inflamatory stimulations activate the CoX-2 of monocytes, macrophages, cells of synovial membrane to synthesize prostaglandin which induce the inflamatory reactions. The non- steroid anti- inflamatory drugs inhibit the CoX-2 so they have anti- inflamatory effects. However, they also inhibit CoX-1 which induce some side effects such as gastrointestinal and kidney accidents, haemorrhage and hypersensitivities. The selective CoX-2 inhibitors have some properties: long half elimination life, easier uptake by oral; the same pharmacokinetics in both elderly and children and uncommon side effects (0.1 -1% treated cases).
Anti-Inflammatory Agents, Non-Steroidal ; Pharmaceutical Preparations ; Cyclooxygenase 2 Inhibitors

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation. There are two kinds of NSAID classified according to the selectivity of COX-2 inhibition: non-selective NSAIDs and cyclooxygenase (COX)-2 inhibitors. Non-selective NSAIDs have a high incidence of gastrointestinal and bleeding-associated adverse events, while COX-2 inhibitors are safer in terms of these events. However, COX-2 inhibitors are thought to cause increased cardiovascular events. The COX-2 inhibitors rofecoxib and valdecoxib were withdrawn from the market over safety concerns. Three COX-2 inhibitors are now available in South Korea after the recent approval of etoricoxib and polmacoxib for osteoarthritis patients. After reviewing the history of and recent studies about the safety of COX-2 inhibitors, physicians should find new uses for old drugs.
Anti-Inflammatory Agents, Non-Steroidal ; Cyclooxygenase 2 Inhibitors* ; Cyclooxygenase Inhibitors ; Humans ; Incidence ; Inflammation ; Korea ; Osteoarthritis ; Prostaglandin-Endoperoxide Synthases

An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.
Acetaminophen ; Analgesia ; Analgesics* ; Analgesics, Non-Narcotic ; Aspirin ; Eating ; Renal Insufficiency ; Renal Insufficiency, Chronic

An association between non-opioid analgesic agents and chronic kidney disease has long been suspected. The presumed development of chronic renal impairment following protracted and excessive use of non-opioid analgesia is known as analgesic nephropathy. Many clinicians accept analgesic nephropathy as a real entity despite the paucity of scientific evidence. This narrative review aims to summarize the literature in the field. The weight of available observational literature suggests that long-term ingestion of paracetamol and combination mixtures of aspirin and paracetamol are likely to contribute to chronic renal impairment. However, there is no convincing data to implicate non-steroidal anti-inflammatory drugs or aspirin monotherapy in the development of analgesic nephropathy. In the absence of high-level evidence, while controversy persists, it may be prudent for physicians to consider all non-narcotic analgesics to be nephrotoxic with long-term use.
Acetaminophen ; Analgesia ; Analgesics* ; Analgesics, Non-Narcotic ; Aspirin ; Eating ; Renal Insufficiency ; Renal Insufficiency, Chronic

A review of the literature on cancer pain revealed that many persons with cancer receive inadequate analgesia for pain control, due in part to a lack of knowledge of the control of cancer pain by both physicians and nurses. This study is composed of two parts : one is to train nurses to change their knowledge of and attitude toward the pain management of patients having cancer and to evaluate the effectiveness of this training in comparison with other non-trained group ; the other is to test the applicability of the pain management method knowledge and attitude in the levels of pain of oncology patients. General characteristics of nurses such as age, education, educational experiences of cancer pain management were not different in both groups except the clinical experience. General characteristics of cancer patients and pain-related variables such as pain, sleep, daily activities, treatment modalities, causes of pain were not different in both groups except the educational levels of patients. After an eight-hour educational program given to the experimental nurse group, the knowledge and attitude about assessment of cancer pain, pain medication, and pharmacological knowledge were significantly higher in the experimental group than in the control group, while knowledge about classification of analgesics was not significantly different. The amount of analgesics, measured by the morphine equivalent doses, used in the experimental group was significantly lower than in the control group in the first and the last days. The experimental group used more systematic ways of drug changes from non-narcotic analgesics to narcotic analgesics than the control group. This indicated that the control group used fentanyl patches more commonly than in the control group. Cancer pain scores of both group of patients were measured on an hourly bases for a week in both groups. The patients' pain scores of the first day of measurement in experimental group were not significantly higher than those of control group of patients, while those of the last day were significantly higher than those of the control group. This study supports the need for educational program for the management of cancer pain to the nurses and the doctors.
Analgesia ; Analgesics ; Analgesics, Non-Narcotic ; Classification ; Education ; Fentanyl ; Humans ; Morphine ; Narcotics ; Pain Management*

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs in the world. NSAID-induced lower gastrointestinal (GI) complications are increasing while upper GI complications are decreasing. Lower GI events accounted for 40% of all serious GI events in patients on NSAIDs. Capsule endoscopy and device assisted enteroscopy are available for detection of small intestinal lesions. Capsule endoscopy studies have demonstrated that NSAIDs use in healthy volunteers raised the incidence (55% to 75%) of intestinal damage. It appears that selective cyclooxygenase-2 inhibitors (coxibs) improved upper and lower GI safety based on results of clinical trials. Selective coxibs are still capable of triggering GI adverse events and cardiovascular toxicity issues were the main focus of concerns. Unfortunately, definite strategies are not available to prevent or heal NSAID-induced intestinal injuries. Thus, there is still a strong clinical need for effective drugs with improved safety profiles than the existing NSAIDs.
Anti-Inflammatory Agents, Non-Steroidal ; Capsule Endoscopy ; Cyclooxygenase 2 Inhibitors ; Humans ; Incidence ; Lower Gastrointestinal Tract