NSAID selection after spine surgery: Loxoprofen vs. celecoxib :- Medznat

For the management of fever, inflammation, and postoperative pain, nonsteroidal anti-inflammatory drugs (NSAIDs) are extensively prescribed.

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Key take away

Both loxoprofen and celecoxib effectively control acute postoperative spinal pain, but loxoprofen acts more rapidly within the first two hours.

Background

For the management of fever, inflammation, and postoperative pain, nonsteroidal anti-inflammatory drugs (NSAIDs) are extensively prescribed. However, no established gold standard exists for controlling acute pain after spinal surgery. This randomized clinical study compared the analgesic efficacy and safety of loxoprofen sodium and celecoxib in patients undergoing spinal surgery, addressing a critical gap in evidence-based postoperative pain management.

Method

A total of 141 patients (mean age: 62.2 years) scheduled for spinal surgery were randomly allocated into two treatment groups:

Loxoprofen sodium group (n = 73): Received 180 mg/day of loxoprofen sodium
Celecoxib group (n = 68): Received 200 mg/day of celecoxib

Both NSAIDs were administered from postoperative day 1 through day 7. Pain intensity was checked via the numeric rating scale (NRS) at 9 standardized time points daily. Laboratory parameters and adverse events, including renal function changes, were systematically monitored to determine drug safety and tolerability.

Result

Comparative analysis revealed no vital difference in daily maximum or mean NRS pain scores between the loxoprofen and celecoxib groups, indicating comparable overall analgesic efficacy for postoperative spinal pain relief. However, loxoprofen showed greater reduction in NRS scores at 30 minutes and 2 hours after administration compared with celecoxib, highlighting a faster onset of action.

This rapid analgesic response was noted in patients with both mild pain (baseline NRS <5) and severe pain (baseline NRS ≥5). Regarding safety outcomes, loxoprofen was discontinued in 1 patient owing to renal dysfunction on day 4, while celecoxib was discontinued in 1 patient on day 2 at personal request.

Conclusion

Both loxoprofen sodium and celecoxib proved effective and well-tolerated NSAIDs for acute pain management following spinal surgery. Notably, a single dose of loxoprofen provided faster and more pronounced early pain relief compared with celecoxib, making it a strong option for rapid postoperative analgesia in spinal surgery patients.