Cyclooxygenase-2 inhibitors in postoperative pain management

Management of acute postoperative pain remains suboptimal; nearly 80 % of the patients report moderate to extreme pain following surgery. Nonselective nonsteroidal antiinflammatory drugs (NSAIDs) have a role in postoperative pain management, but conventional NSAIDs can cause gastrointestinal ulceration, renal injury, and disruption of platelet function and hemostasis. Recently, cyclooxygenase-2 (COX-2) specific inhibitors such as rofecoxib and celecoxib were devoleped to provide the increased efficacy of non-specific NSAIDs while limiting associated side effects. These drugs have demonstrated analgesic efficacy and opioid sparing effect after variety of surgical procedures. This article will review the role and outcome of COX-2 inhibitors for postoperative pain management.