Pakistan Journal of Pharmaceutical Sciences

Abstract: Background: Pediatric fractures are common, with high postoperative moderate-to-severe pain incidence, hindering recovery. Celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, has analgesic/anti-inflammatory effects, but its perioperative efficacy and impact on fracture healing in children remain understudied. Objective: To evaluate celecoxib’s efficacy for perioperative pain management and its effects on fracture healing/imaging outcomes in children with fractures. This study aimed to evaluate the efficacy of celecoxib in children's fracture perioperative pain management and its impact on fracture healing and imaging outcomes. Methods: We employed a retrospective, consecutive sampling method to analyze medical records of 84 children who underwent surgery for fractures from January 2023 to December 2024. Postoperatively, they were divided into celecoxib (n=44) and tramadol hydrochloride (n=40) groups. Pain scores and healing times were monitored. In the celecoxib group, computed tomography (CT) images were compared to pre- and post-treatment. Results: Visual Analog Scale (VAS) scores decreased significantly from T0 (before medication) to T1 (4 weeks after operation) and T2 (3 months after operation) in both groups (P<0.001), more so in celecoxib (P1=0.008, P2<0.001). COX-2 and prostaglandin E2 (PGE2) levels also significantly dropped from T0 to T1 and T2 (P<0.001), with celecoxib showing greater reductions (P1=0.036, P2=0.047). Fracture healing times were comparable (P>0.05). Post-treatment CT images showed blurred fracture lines in the celecoxib group. Adverse reaction rates were similar (9.09% vs 15.00%; P>0.05). Conclusion: Celecoxib effectively alleviates pain and inflammation without hindering fracture healing in children, suggesting its potential as a perioperative analgesic.