Effectiveness of COX-2 Inhibitors as Preemptive Analgesia in Total Knee Arthoplasty Surgery

Abstract

Post-operative pain, especially TKA procedures, is a problem that is often encountered. The use of adequate analgesics is the main treatment to reduce the side effects of pain, namely immobilization, decreased range of motion (ROM), increased risk of thromboembolism and decreased success rate of rehabilitation. Several previous studies reported the possibility of a significant therapeutic effect on the postoperative pain response by using preemptive analgesia methods with cyclooxygenase-2 inhibitors (COX-2 inhibitors). The aim of this study was to determine the effectiveness of COX-2 inhibitors using the preemptive analgesia method in total knee arthroplasty surgery through a literature study. Data searches were carried out on several electronic journal databases PubMed, ProQuest and Google Scholar, with the keywords "cyclooxygenase 2 inhibitors", "COX-2 inhibitor", "celecoxib", "valdecoxib", "rofecoxib", "etoricoxib", "non- steroidal anti-inflammatory drugs”, “preoperative analgesia”, and “total knee arthroplasty”. in 2013-2022. Overall, the study showed a significant response to the use of COX-2 inhibitors in preemptive analgesia methods to suppress the pain response at rest and during knee flexion after TKA when compared with the control group. The PA method with COX-2 inhibitors has also been proven to be successful in reducing the level of use of salvatory analgesics, which indirectly indicates that pain control has been successful. COX-2 inhibitors have been proven to be effective in reducing the pain response as a preemptive analgesia method in patients undergoing TKA procedures.