Objective  To systematically evaluate the efficacy and safety of celecoxib for preemptive analgesia in patients undergoing orthopedic surgery.

Methods  PubMed, Embase, Web of Science, the Cochrane Library, Wanfang database, CNKI, VIP and SinoMed were systematically searched to collect randomized controlled trials about the use of celecoxib for preemptive analgesia in patients undergoing orthopedic surgery. RevMan 5.4 software was used for Meta-analysis.

Results  A total of 11 RCTs were included, with a total of 985 patients. The results of the Meta-analysis showed that in the resting state, the VAS scores of patients in the trial group were significantly lower than those in the control group at 12 h [MD=-0.48, 95%CI (-0.83, -0.14), P=0.006], 24 h [MD=- 0.40, 95%CI (-0.58, -0.21), P<0.000 1], 48 h [MD=-0.31, 95%CI (-0.51, -0.11), P=0.002] and 72 h [MD=-0.21, 95%CI (-0.34,  -0.07), P=0.003] after surgery. In the active state, the VAS scores of patients in the trial group were significantly lower than those in the control group at 6 h [MD=-0.49, 95%CI (-0.86, -0.11), P=0.01], 24 h [MD=-0.46, 95%CI (-0.68,  -0.24), P<0.000 1], 48 h [MD=-0.24, 95%CI (-0.44, -0.05), P=0.02] after surgery. There was no statistically significant differences in the VAS scores between the two groups at 6h after surgery in the resting state and at 72  h after surgery in the active state (P>0.05). The incidence of postoperative nausea and vomiting [RR=0.72, 95%CI (0.57, 0.91), P=0.006] and cardiovascular adverse reactions [RR=0.24, 95%CI (0.06, 0.93), P=0.04] was significantly lower in the trial group than in the control group. There was no statistically significant difference in the incidence of postoperative constipation, dizziness, somnolence, and skin itching between the two groups (P>0.05).

Conclusion  In orthopedic surgery, the use of celecoxib for preemptive analgesia can alleviate early postoperative pain and reduce the incidence of postoperative nausea, vomiting, and cardiovascular adverse reactions in patients..

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