Parecoxib May Be Superior to Ketorolac for Oral Surgery-Associated Pain

The following article is part of conference coverage from the IASP 2018 conference in Boston, Massachusetts. Clinical Pain Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in pain medicine. Check back for the latest news from IASP 2018.

Parecoxib may be effective for postoperative pain following oral surgery and may be associated with fewer side effects than ketorolac, according to a study to be presented at the 2018 World Congress on Pain, held September 12-16 in Boston, Massachusetts.

For this study, 807 individuals (ages ≥18) scheduled to undergo surgical extraction of at least 2 ipsilateral affected third molars that required bone removal, were randomly assigned to receive placebo (n=201), ketorolac (n=202; 30-60 mg intravenous [IV] or intramuscular injection [IM]), or parecoxib (n=404; 20-40 mg IV or IM). Patients were assessed over a 24-hour period for onset analgesia (based on Kaplan-Meier estimates) and time-specific pain levels.

Onset of analgesia was found to be faster in patients administered parecoxib and ketorolac vs placebo. The analgesic effect appeared to last longer in patients who received parecoxib vs ketorolac. Nausea and vomiting were less common in patients who received parecoxib (8.7% and 2.7%, respectively) compared with ketorolac (18.3% and 6.9%, respectively) and placebo (23.4% and 11.4%, respectively).

“Parecoxib IV or IM is a viable alternative to opioid analgesics for acute postoperative pain relief for patients following oral surgery,” concluded the study authors.

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Multiple authors declare a relationship with Pfizer which manufactures parecoxib.


Salomon, I, Wallentin A, Salomon P, Pan S, Essex MN. Parecoxib for the treatment of postoperative pain after oral surgery: a pooled, post-hoc analysis. Presented at the World Congress on Pain 2018; September 12-16, 2018; Boston, MA. Poster 63910. 

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