The Influence of Etoricoxib on Pain Control for Laparoscopic Cholecystectomy: A Meta-analysis of Randomized Controlled Trials

Abstract

Introduction: The efficacy of etoricoxib on pain control for laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the impact of etoricoxib on pain intensity after laparoscopic cholecystectomy. Materials and Methods: We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2018 for randomized controlled trials assessing the effect of etoricoxib versus placebo on pain management after laparoscopic cholecystectomy. This meta-analysis was performed using the random-effect model. Results: Four randomized controlled trials involving 351 patients are included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, etoricoxib has no important impact on pain scores within 4 hours [mean difference (MD)=−1.48; 95% confidence interval (CI)=−3.54 to 0.58; P=0.16] and 8 hours (MD=−0.65; 95% CI=−1.43 to 0.12; P=0.10), but can significantly decrease pain intensity within 12 hours (MD=−1.16; 95% CI=−1.93 to −0.38; P=0.003) and 24 hours (MD=−1.10; 95% CI=−1.98 to −0.22; P=0.01), as well as postoperative analgesic consumption (standard MD=−1.21; 95% CI=−2.19 to −0.23; P=0.02), with no increase in nausea and vomiting (risk ratio=0.68; 95% CI=0.42-1.10; P=0.11), and headache (risk ratio=0.96; 95% CI=0.44-2.09; P=0.92). Conclusions: Etoricoxib can substantially reduce pain intensity in patients with laparoscopic cholecystectomy.