Celecoxib Reduces Opioid Use After Surgery in Head and Neck Cancer

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The mean total opioid morphine equivalent use in the celecoxib arm was 31.8 mg vs 45 mg in the control arm.
The mean total opioid morphine equivalent use in the celecoxib arm was 31.8 mg vs 45 mg in the control arm.
The following article features coverage from the American Head & Neck Society (AHNS) 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

Post-operative pain management with celecoxib significantly reduces opioid use among patients with head and neck cancer who undergo free tissue reconstruction, according to an oral presentation at the 2018 American Head & Neck Society Annual Meeting in National Harbor, Maryland.1

Pain after head and neck cancer surgery is often treated with opioids, though patients can experience treatment-related respiratory depression, constipation, nausea, and drug dependence. Celecoxib, an analgesic used for acute pain, may reduce the need for opioids in this setting.

For this retrospective matched-cohort study, researchers evaluated the outcomes of 101 patients who underwent head and neck cancer surgery with free tissue reconstruction. Fifty-one patients received celecoxib 200 mg twice daily in addition to opioids and were matched to 50 patients who were managed only with opioids according to cancer stage and site.

There was a significant reduction in opioid use among patients in the celecoxib arm vs the control arm. Patients treated with celecoxib had a daily mean opioid use of 29.4 mg vs 39.5 mg in the control arm (P = .04). The mean intravenous opioid use decreased nearly 3.5-fold (P < .001) in the celecoxib arm.

The mean total opioid morphine equivalent use in the celecoxib arm was 31.8 mg vs 45 mg in the control arm (P = .03).

No increases in risk for surgical site infection, flap dehiscence, hematoma, or free flap failure rate were observed in patients who received celecoxib.

The authors concluded that “celecoxib may be a safe adjunctive analgesic to consider in select [head and neck cancer] patients after free tissue reconstruction to help decrease opioid requirements. Future search should focus on prospective randomized trials and patient reported outcomes—pain scores and [quality of life] measures.”

Read more of Cancer Therapy Advisor's coverage of the American Head & Neck Society (AHNS) 2018 meeting by visiting the conference page.

Reference

  1. Carpenter P, McCrary H, Torrecillas V, et al. Celecoxib decreases acute postoperative opioid requirements after head and neck reconstruction with free tissue transfer: a matched cohort study. Oral presentation at: 2018 American Head & Neck Society Annual Meeting; April 18-19, 2018; National Harbor, MD.

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