Assessing Pre-Emptive Analgesic Strategies in Total Knee Arthroplasty: A Comparative Study of Etoricoxib, Pregabalin, and Celecoxib

Abstract

Background: Pre-emptive analgesia is an approach to pain management that aims to block pain pathways before surgery begins, reducing postoperative discomfort. This study explored the effectiveness of three commonly used pre-emptive analgesics-etoricoxib, pregabalin and celecoxib in patients undergoing total knee arthroplasty (TKA).

Methods: It is a randomized controlled trial, patients were divided into three groups: one group received Etoricoxib (120 mg), another received Pregabalin (75mg), and the third received Celecoxib (200 mg). All medications were given 1 hour before surgery. Pain levels were assessed at rest and during activity using the Visual Analog Scale (VAS) at 6, 12, 24, 48 and 72 hours postoperatively. Additional measures included the need for rescue pain medication

Results: Etoricoxib and pregabalin provided better pain relief than celecoxib, especially during activity at 6 and 72 hours after surgery (P < 0.001). Pregabalin was particularly effective at managing nerve-related pain, while etoricoxib offered quick anti-inflammatory effects. Celecoxib showed moderate pain control but was slower to act. Patients in the etoricoxib and pregabalin groups also required fewer rescue analgesics (P < 0.05). No serious side effects were reported in any group.

Conclusions: This study highlights etoricoxib and pregabalin as effective options for pre-emptive pain management in TKA, outperforming celecoxib in both early and late stages of recovery. Incorporating these drugs into a multimodal analgesic strategy can improve patient comfort and recovery outcomes.