关键词: 正颌外科, 超前镇痛, 塞来昔布, 围手术期

Abstract: Objective: To investigate the analgesic effect and safety of preemptive use of celecoxib in orthognathic surgery. Methods: Seventy-one patients undergoing bimaxillary orthognathic surgery were randomly divided into the experimental group and the placebo group. Patients in the experimental group received 400 mg celecoxib oral 2 hours before surgery, followed by 200 mg celecoxib twice daily for 4 days postoperatively. The placebo group received a placebo at the same time point as the experimental. All patients underwent the same orthognathic surgery, with identical anesthesia methods and postoperative treatments. Pain scale after surgery was assessed using the Wong-Baker Faces Pain Rating Scale from the time of awakening until the fourth postoperative day. Blood loss and additional analgesic requirements and adverse reactions were recorded. Results: The postoperative pain in the experimental group were significantly lower than those in the placebo group (P＜0.05). The incidence of pain complaints and the use of additional analgesics were significantly reduced in the experimental group. However, there was no statistically significant difference in pain scores between two groups from awakening to the first postoperative day in patients undergoing segmental Le FortⅠ maxillary osteotomy. The incidence of postoperative nausea and vomiting showed no statistical difference between two groups. No other medication-related adverse reactions were observed, and there was no statistically significant difference in intraoperative blood loss between two groups. Conclusion: Preemptive analgesia with celecoxib significantly reduces postoperative pain in patients after orthognathic surgery, but its effect is not significant in patients undergoing segmental Le FortⅠ maxillary osteotomy. Furthermore, it does not increase intraoperative blood loss or other adverse reactions.

Key words: orthgnathic surgery, preemptive analgesia, celecoxib, perioperative period