The goal of using parecoxib, an intravenous cyclooxygenase-2 inhibitor as a non-opioid analgesic in the multimodal pain management protocol is to reduce the incidence of opioid-related adverse events, including nausea and vomiting, dizziness, pruritus, constipation, urinary retention, sedation, impaired cognition, respiratory depression and possible death29. Here, PTGS2 is linked to Respiratory insufficiency due to muscle weakness.