Study on the efficacy and safety of paricoxib for pain relief after hepatic artery chemoembolization in hepatocellular carcinoma

Zhang Yijie; Zhao Ge; Guo Qiang; Gao Xiaomeng; Dang Caiyan

doi:10.3760/j.issn.1673-4777.2023.12.016

Abstract：Objective To explore the effectiveness and safety of paricoxib for pain control in patients with hepatocellular carcinoma undergoing hepatic artery chemoembolization(TACE)treatment.Methods Totally 213 hepatocellular carcinoma patients who received TACE treatment from Xi'an Central Hospital Affiliated to Xi'an Jiaotong University from January 2020 to January 2023 were selected.They were completely randomized into celecoxib group,paricoxib group,and oxycodone group,with 71 cases in each group.The patients received treatment with celecoxib,paricoxib,or oxycodone immediately after TACE(To),and took it once every 12 h(12,24 and 36 h after TACE noted asT12,T24 and T36)within 48 h after TACE.The pain scores of the three groups were evaluated and compared at each time point.The independent risk factors for pain in patients at time point of highest pain score were analyzed.The occurrence of adverse reactions was observed.Results The highest pain score of all three groups of patients appeared at T12.At T12,the highest pain score in the paricoxib group was lower than those in the celecoxib group and oxycodone group[(2.75±0.23)vs(4.40±0.23),(4.17±0.26)],and at T24,the pain score in the paricoxib group was lower than that in the celecoxib group(all P＜0.05).The results of Logistic regression analysis showed that liver parenchymal embolization,gallbladder endovascular embolization,and prophylactic pain relief using non paricoxib were independent risk factors for pain in patients with T12(all P＜0.05).There were 2 cases of vomiting(2.8％),and 1 case of constipation(1.4％)in the celecoxib group,1 case of pain(1.4％),3 cases of vomiting(4.2％),and 3 cases of constipation(4.2％)in the paricoxib group,and 2 cases of pain(2.8％),6 cases of vomiting(8.4％),and 5 cases of constipation(7.0％)in the oxycodone group.Conclusion Among hepatocellular carcinoma patients receiving TACE treatment,paroxycoxib has a better analgesic effect than oxycodone and celecoxib,and has fewer adverse reactions.