OBJECTIVE To evaluate the clinical comprehensive value of parecoxib for perioperative pain management in elderly patients undergoing hip surgery under the concept of enhanced recovery after surgery, in accordance with the requirements and methods of clinical comprehensive evaluation of drugs, so as to provide a reference for drug selection and rational drug use in medical institutions.

METHODS Firstly, a preliminary comprehensive clinical evaluation index system encompassing six dimensions, including safety, effectiveness, economy, suitability, innovation, and accessibility, was constructed through literature review and group discussion. Secondly, the Delphi method was employed to evaluate and screen the core content of the evaluation index system. Finally, methods such as evidence-based medical research(systematic review of literature) and real-world data research(prospective, observational cohort study), along with information sources like drug instructions, were utilized to conduct a qualitative and quantitative integrated analysis of the indicators in the perioperative pain management of elderly patients undergoing hip surgery with parecoxib, based on the established index system.

RESULTS The result of the systematic review indicated that parecoxib demonstrated superior safety and effectiveness compared to placebo and opioids in the perioperative pain management for elderly patients undergoing hip surgery. Real-world study results further suggested that parecoxib offered better safety and effectiveness than opioids in postoperative pain management for elderly patients undergoing hip surgery. In terms of economics, parecoxib exhibited cost and effectiveness advantages over opioids in postoperative use for elderly patients undergoing hip surgery, making it more economical. In terms of innovation, parecoxib had innovative potential in terms of its indications and clinical medication needs, albeit with moderate innovation. In terms of suitability, parecoxib was well-suited for nurses, pharmacists, and patients. Regarding accessibility, parecoxib had a high hospital equipment rate and market coverage, with the cost of a treatment course accounting for a relatively low proportion of per capita consumption expenditure, indicating high availability and affordability, and thus good accessibility.

CONCLUSION Parecoxib demonstrates favorable performance across the six dimensions when used for perioperative pain management in elderly patients undergoing hip surgery, indicating its high clinical comprehensive value.