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Anxiety sensitivity is the characteristic of being fearful of anxiety-related sensations.
The study postulates that parecoxib possesses an anxiolytic effect and with further research, it can be considered as a new prophylactic regime or treatment modality in the management of pain-related anxiety.
Anxiety sensitivity is the characteristic of being fearful of anxiety-related sensations. It is one of the important factors linked to the experience of pain. During the preoperative period, the patients usually experience this unusual feeling, making them more susceptible to pain after surgery. Anxiety sensitivity is not only linked to greater pain experience rather incline patients more towards the negative thoughts or sensations of painful stimuli and therefore, towards a greater intensity of reported pain. Continuous femoral nerve block (CFNB) affords a commonly performed practice in surgical procedures of total knee arthroplasty (TKA) as an effective means of providing postoperative analgesia. Previous studies have suggested that sedatives/tranquilizers may provide benefit to the patients with pain-related anxiety while some other studies have reported serious adverse effects with the regular use of benzodiazepines, opioids, and ketamine or fentanyl. Intravenous administration of parecoxib could provide significant pain relief in surgical operations that require additional forms of analgesia. However, there is not much data known about its effects on the anxiety levels of patients before a surgical procedure.
Rationale behind research:
Very little is known about the effects of parecoxib on the anxiety levels of patients, when regularly being administered during the perioperative period. The authors addressed this great area of unmet need by evaluating the effects of intravenous parecoxib on anxiety levels experienced during the perioperative period.
Objective:
To investigate the effects of intravenous parecoxib, pre-emptively administered, on the anxiety levels experienced during the perioperative periods.
NOTE: Continuous femoral nerve block was placed in a sterile fashion with neurostim guidance.
Study outcomes
Pain: Parecoxib provided greater relief than placebo following TKA.
Anxiety levels: The group receiving parecoxib had lower anxiety levels both pre- and post-surgically, as compared to the placebo group, with statistical significance p = 0.012 and p = 0.002. Also, STAI 2 afforded the more appropriate tool to evaluate the anxiety levels during the current perioperative period, which undoubtedly can be very stressful for any individual. Nevertheless, we considered the use of STAI 1 valuable to extract information about the patient’s personality, in general.
Figure 1: Anxiety levels of pre-surgical state and post-surgical state b/w groups receiving parecoxib and placebo
In the current study, administration of parecoxib had statistically significantly improved anxiety levels for both trait and state anxiety levels, as compared to the placebo.
The current findings are in agreement with the previous study that investigated whether parecoxib, preemptively administrated, had an effect on anxiety levels during epidural catheter placement for surgical operations. Administaration of 40 mg parecoxib, intravenously 20 min before the interventional technique, improved patients’ anxiety levels, experienced prior to an epidural catheter placement.
Anxiety levels measured were indeed associated with the personality characterstics and not the procedure followed.
This study imparts a valuable information about the anxiolytic effect of parecoxib in patients undergoing TKA with continous femoral block. However, further studies are required to explain the relationships and mechanisms between anxiety and pain association.
Pain Ther. 2016 Feb 9.
Parecoxib Possesses Anxiolytic Properties in Patients Undergoing Total Knee Arthroplasty: A Prospective, Randomized, Double-Blind, Placebo-Controlled, Clinical Study
Despoina G. Sarridou et al.
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