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OBJECTIVE To systematically evaluate the effectiveness and s afety of parecoxib sodium for gynecological surgery postoperative analgesia ，and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed ， Embase，the Cochrane Library ，CNKI，VIP，Wanfang data and SinoMed during the inception to Feb. 16th，2021，randomized controlled trials （RCT） about parecoxib sodium （trial group ） versus 0.9％ sodium chloride injection （control group ） for gynecological surgery and postoperative analgesia were collected. After screening literatures ，extracting data and evaluating the quality of literatures with modified Jadad scale ，Meta-analysis，sensitivity analysis and publication bias analysis were performed by using RevMan 5.3 software. RESULTS A total of 14 RCT were included ，involving 1 120 patients. The results of Meta-analysis showed that visual analogue scale （VAS）score at 4 h after operation [MD ＝－1.65，95％CI（－2.48，－0.82），P＝0.000 1]，VAS score at 6 h after operation [MD ＝－1.03，95％CI（－1.60，－0.45），P＝0.000 5]，VAS score at 12 h after operation [MD ＝－0.98， 95％CI（－1.38， －0.59），P＜0.000 01]，the proportion of postoperative analgesia requirements [OR ＝0.14，95％CI（0.04， 0.50），P＝0.003] and the dosage of morphine [MD ＝ －17.75， com 95％CI（－20.93，－14.56），P＜0.000 01] in trial group were significantly lower than control group. There was no statistical significance in the incidence of nausea between 2 groups [OR＝ 0.68，95％CI（0.43，1.08），P＝0.10]. The results of sensitivity analysis showed that the above results were basically stable. The results of publication bias analysis showed that there was little possibility of publication bias in this study. CONCLUSIONS Parecoxib sodium is effective and safe for gynecological surgery and posto perative analgesia.
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Objective @# To compare the analgesic effect and safety of bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump in analgesia after orthognathic surgery.@*Methods @#Forty patients with simple ascending sagittal split osteotomy and ankle plasty were randomly divided into the experimental group and the control group, with 20 patients in each group. The experimental group received 2 mL 1% ropivacaine by inferior alveolar nerve block anesthesia on both sides. Immediately after surgery, parecoxib sodium 40 mg was intravenously administered. The control group was given an intravenous analgesia pump for analgesia. Pain intensity (VAS pain score) and Ramsay sedation score were recorded at 2 h, 4 h, 8 h, 24 h, 48 h after operation, and the incidence of postoperative adverse reactions was observed.@*Results@#There was no significant difference in pain intensity and Ramsay sedation score between the two groups at each time point (P>0.05). During the analgesic treatment, the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group (P<0.05).@*Conclusion@# Bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump are effective for analgesia after mandibular orthognathic surgery, but the former has a lower incidence of adverse reactions, more suitable for analgesia after mandibular orthognathic surgery.
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Objective@#To investigate the effect of preoperative use of paracetin sodium on epidural pain and coagulation in patients with epidural hematoma.@*Methods@#80 brain trauma patients with epidural hematoma underwent surgery were selected, and they were randomly divided into two groups according to the digital table, 40cases in each group.30min before surgery, the observation group was given parecoxib sodium, and the control group was treated with the same volume of 0.9% saline.Then, the changes of the visual analogue scale (VAS score) and PCIA compression times were compared between the two groups at 6h, 12h, 24h and 48h after operation.The coagulation changes were observed.@*Results@#6h, 12h, 24h and 48h after operation, the VAS scores of the pain in the observation group were (4.1±0.3)points, (4.0±0.2)points, (3.0±0.3)points and (2.3±0.3)points, respectively, which were lower than those in the control group(t=17.541, 3.508, 7.589 and 28.284, all P<0.05).6h, 12h, 24h and 48h after operation, the PCIA times in the observation group were (1.9±0.4)times, (1.8±0.3)times, (1.1±0.2)times and (0.7±0.1)times, respectively, which were lower than those in the control group (t=4.939, 3.795, 12.279 and 16.000, all P<0.05). The PT, TT, APTT and Fib between the two groups had no statistically significant differences (t=0.407, 0.000, 1.491 and 0.331, all P>0.05).@*Conclusion@#Preoperative use of parecoxib sodium can effectively reduce the perioperative pain in patients with epidural hematoma, and it has no effect on coagulation function with high safety.
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Objective To investigate the preemptive analgesic effect and safety of paracoxib sodium in patients under-going endoscopic submucosal dissection(ESD). Methods A total of 80 ASA I or II patients aged 35-65 years undergoing ESD under general anesthesia were randomized into two groups(n=40 each):parecoxib sodium group(group B) was received intrave-nous parecoxib sodium 40 mg (in 5 mL 0.9% sodium chloride solution) 10 min before anesthesia induction and control group (group A)was received 0.9% sodium chloride solution 5 mL instead of parecoxib sodium.At the end of operation,patients in both groups were received 5 mg of dezocine.Blood samples were analyzed for PT,TT,APTT,Fib,PLT and PAgT before induction of an-esthesia,at 30 min and 120 min after operation.Patients'Visual analogue scale(VAS),Numeric sedation scale(NSS),and ad-verse reactions were recorded at the end of the operation,2,4 and 6 h after operation. Results Compared with those before parecoxib sodium administration,the fibrinogen concentration and PAgT were significantly higher in group B at 30 min after the intravenous injection of parecoxib sodium(P<0.05),while there was no significant difference in PT,TT,APTT and platelet count between group B and group A(P>0.05).VAS at the end of operation,2,4 and 6 h after operation were lower in group B(P<0.05),and the patients were more satisfied in group B(P<0.05). Conclusion Parecoxib could temporarily enhance blood co-agulation in patients undergoing ESD and could offer safe and effective analgesia.
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Objective To investigate the effect of intrathecal parecoxib sodium in bone tumor pain of rats. Methods Bone tumor pain was induced by injection of MRMT-1 tumor cells (1 × 104/L) into the tibia of female SD rats under sevoflurane anesthesia. The development of bone tumor was monitored by radiological study, and histological sections stained with hematoxylin and eosin. At 3 d after MRMT-1 tumor cell injection, a PE-10 catheter was inserted into the intrathecal space for drug administration. At 10 d after MRMT-1 tumor cell injection, rats were randomly divided into 5 equal groups, control group, parecoxib sodium 0.1, 0.3, 1.0 and 3.0 g/L group. For pain assessment, a withdrawal threshold was measured using von Frey filament being applied to the tumor cell inoculation site. The effects of intrathecal saline or parecoxib sodium were investigated. Results Intra-tibial injection of MRMT-1 tumor cells produced a bone tumor in radiologic and pathologic findings.Also, the paw withdrawal threshold was significantly decreased(mechanical allodynia).Percentage of the maximal possible effect (% MPE) of control group and parecoxib sodium 0.1, 0.3, 1.0 and 3.0 g/L group was (13.89 ± 4.17)%,(7.54 ± 3.91)%,(57.47 ± 11.47)%,(85.72 ± 9.42)% and(100.00 ± 0.00)%,compared with control group, intrathecal parecoxib sodium dose-dependently increased the withdrawal threshold (P<0.05).Conclusions Intrathecal parecoxib sodium reduces bone tumor-related pain behavior.
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Objective To explore the effect and safety of dexmedetomidine and parecoxib sodium alone or in double combinations in improving restlessness in recovery period in patients undergoing thoracic surgery.Methods One hundred and twenty eight patients who underwent thoracic surgery in the Central Hospital of Xinyang from September 2014 to September 2016 were selected and randomly divided into control group,dexmedetomidine group,parecoxib sodium group and combined group,with 32 cases in each group.Patients in the dexmedetomidine group were given 10 mL of saline at 0.5 h before surgery,and were given a slow injection of 0.5 μg · kg-1 of dexmedetomidine by intravenous injection at 10 minutes before the end of the operation.Patients in the parecoxib group were given 40 mg (10 mL) of parecoxib sodium 0.5 h by intravenous injection before surgery.Patients in the combined group were given 40 mg (10 mL) of parecoxib sodium 0.5 h by intravenous injection before surgery,and were given a slow injection of 0.5 μg · kg-1 of dexmedetomidine intravenously at 10 minutes before the end of the operation.Patients in the control group received intravenous injections of equal saline at 0.5 h before surgery and 10 minutes before the end of the operation.The operation time,peroperative bleeding,peroperative infusion volume,and anesthesia time were observed.Plasma tumor necrosis factor-α (TNF-t),C reactive protein (CRP) and interleukin-10 (IL-10) levels and TNF-α/IL-10 of all patients at the time of 10 min before induction of anesthesia (T0),15 min before extubation (T1),tracheal extubation time (T2),15 min after extubation (T3) were detected.At the same time,restlessness in stage of analepsia and sedation of all patients were evaluated.The adverse reactions of the four groups in the recovery stage were statistically analyzed.Results There was no significant difference in the operation time,peroperative bleeding,peroperative infusion volume and anesthesia time among the four groups(P ＞ 0.05).The levels of TNF-α,CRP and IL-10 at T1,T2 and T3 in the four groups were significantly higher than those at T0 (P ＜ 0.05).The levels of TNF-α,CRP,IL-10 at T2 and T3 were higher than those at T1 (P ＜0.05),but the levels of them at T3 were lower than those at T2 in the four groups(P ＜0.05).The TNF-α/IL-10 at T1,T2 and T3 in the control group was significantly higher than that at T0 (P ＜ 0.05),and TNF-α/IL-10 at T1,T2 and T3 in the other three groups was significantly lower than that at T0 (P ＜ 0.05).The level of TNF-α/IL-10 at T2 and T3 was higher than that at T1,at T3 it was higher than that at T2 in the control group(P ＜ 0.05) . But there was no significant difference among the time point of T1,T2 and T3 in the other three groups(P ＞ 0.05).Compared with the control group,TNF-α,CRP and TNF-α/IL-10 levels at T1,T2 and T3 in the other three groups were significantly lower(P ＜ 0.05),and IL-10 levels were significantly higher(P ＜0.05).The levels of TNF-α,CRP and TNF-α/IL-10 at T1,T2 and T3 in the combined group were significantly lower than those in dexmedetomidine group and parecoxib sodium group(P ＜ 0.05),while the IL-10 levels were significantly higher(P ＜ 0.05).The restlessness rate in the dexmedetomidine group,parecoxib sodium group and combined group were significantly lower than that in the control group (P ＜ 0.05),while the ramsay sedation was significantly higher (P ＜ 0.05).The restlessness rate in combined group was significantly lower than that in dexmedetomidine group and parecoxib sodium group (P ＜ 0.05).All the patients had no tachycardia,nausea,vomiting,respiratory depression and other adverse reactions.Conclusion Dexmedetomidine combined with parecoxib can reduce the restlessness rate significantly,and can produce some inhibition to the inflammatory reaction.The clinical effect of dexmedetomidine combined with parecoxib is better than dexmedetomidine and parecoxib sodium alone.
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Objective To investigate the effects of perioperative parecoxib sodium on serum surfactant protein A and inflammatory response in elderly patients undergoing video-assisted thoracoscopic pneumonectomy,Methods Sixty-two ASA Ⅰ or Ⅱ elderly patients,aged 65-78 years,weighing 51-79 kg,scheduled for elective video-assisted thoracoscopic pneumonectomy under general anesthesia,were randomly divided into 3 groups:0.3 mg/kg parecoxib sodium group (group P1,n=21),0.6 mg/kg parecoxib sodium group (group P2,n =21) and control group (group C,n =20).The patients were given intravenous parecoxib sodium of 0.3 mg/kg immediately before induction of anesthesia and at 12 h after operation in group P1,and also parecoxib sodium of 0.6mg/kg immediately before induction of anesthesia and at 12 h after operation in group P2,while the equal volume of normal saline was given in group C.Blood samples were taken from the central vein before the induction of anesthesia(T0),after operation(T1),12 h after operation(T2) and 24 h after operation(T3).The concentration of serum surfactant protein A (SP-A),TNF-α,IL-6 and IL-8 were determined by ELASA.The incidence of pulmonary complications at 72 h after operation were also recorded.Results Compared with T0,the concentration of serum SP-A,TNF-α,IL-6 and IL-8 increased significantly in all groups at T1-T3 (P＜0.05).Compared with C group,the concentration of serum SP-A,TNF-α,IL-6 and IL-8 in groups P1 and P2 decreased significantly at T1-T3 (P＜0.05),there were no significant differences between groups P1 and P2.The incidence of postoperative pulmonary complications had no statistically significant differences between the three groups.Conclusion Parecoxib sodium can significantly reduce the concentration of serum SP-A and alleviate the inflammatory response in elderly patients undergoing video-assisted thoracoscopic pneumonectomy.
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<p><b>OBJECTIVE</b>To observe the analgesic and sedative effects of acupuncture combined with local anesthesia for percutaneous vertebroplasty (PVP).</p><p><b>METHODS</b>Sixty patients of single segmental osteoporotic vertebral compression fractures who were prepared to receive PVP were randomly divided into an observation group, a control 1 group, a control 2 group, 20 cases in each group. The patients in the observation group were treated with electroacupuncture (EA) at Hegu (LI 4), Neiguan (PC 6) and Zusanli (ST 36) 20 min before operation; during operation, EA was given combined with regular anesthesia. The patients in the control 1 group were treated with intramuscular injection of parecoxib sodium (40 mg), combined with regular anesthesia. The patients in the control 2 group were treated with intravenous injection of dezocine (5 mg), combined with regular anesthesia. Visual analogue scale (VAS) and Ramesy sedation score were compared among the three groups.</p><p><b>RESULTS</b>In the observation group and control 2 group, the VAS during puncture and bone cement placement was higher than that before acupuncture (all <0.01); the VAS during bone cement placement was higher than that before puncture (<0.05, <0.01); the VAS after operation was lower than that during puncture and bone cement placement (<0.05, <0.01). In the control 1 group, the VAS during puncture and bone cement placement and after operation was higher than that before acupuncture (<0.01, <0.05), the VAS after operation was lower than that during puncture and bone cement placement (<0.05, <0.01). There was no significant difference in VAS and Ramesy score among three groups at all time points (all >0.05).</p><p><b>CONCLUSION</b>Compared with local anesthesia and analgesics, acupuncture combined with local anesthesia has similar analgesic and sedative effect for PVP, which could be considered a better method for PVP anesthesia.</p>
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@#Objective To clearly define and describe the difference of analgesic actions and side effects between dezocine and parecoxib sodium in video-assisted thoracic surgery (VATS) lobectomy. Methods Ninety patients underwent thoracotomy (lobectomy) and were hospitalized in the Department of Thoracic Surgery, West China Hospital, Sichuan University between August 2015 and January 2016. Patients were randomly divided into two groups including a parecoxib sodium group (a PG group, 43 patients) and a dezocine group (a DG group, 47 patients). We analyzed the occurrence of side effects in the two groups, as well as other outcomes including visual analogous scores and location of the pain et al. Results The occurrences of nausea, vomit and abdominal distention in the PG group (9.30%, 2.33%, 13.95%) were significantly lower than those of the DG group (25.53%, 17.02%, 40.43% , P=0.046, P=0.032, P=0.009) in the early period after operation. Pain scores at the postoperative 12 h, 24 h, 48 h and 72 h in the PG group (2.56±0.96, 2.47±0.96, 1.93±0.99, 0.98±1.24) were better than those of the DG group (4.00±1.60, 3.62±1.48, 3.36±1.55, 2.47±1.78, P=0.000, P=0.000, P=0.000, P=0.002). And the same results were found in the postoperative coughing VAS assessment. The mostly reported pain location was the chest drainage, incision site and chest wall in turn. Postoperative pain properties, in turn, were swelling, stabbing pain and numbness. Conclusion Postoperative pain after VATS lobectomy may be adequately controlled using parecoxib sodium. The low pain scores and decreased adverse effects are achieved.
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OBJECTIVE: To prepare parecoxib sodium freeze-dried preparation, evaluate and validate the feasibility of the production process and quality reliability of the preparation. METHODS: Risk assessment of the production process of parecoxib sodium freeze-dried preparation was performed based on the method of quality by design (QbD).The key steps and key process parameters were identified.The critical quality attributes (CQAs)of the intermediates and final product were clarified, the validation protocol and acceptable standard were accordingly developed, and the production process was validated. RESULTS: The production process of parecoxib sodium freeze-dried preparation met the GMP requirements, and the intermediate and final products met the quality standards. CONCLUSION: The established production process of parecoxib sodium freeze-dried preparation is feasible and the product quality is controllable.
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Objective To investigate the application effect of psychological intervention combined with parecoxib in rehabilitation of patients with bile duct carcinoma after the operation. Methods According to the different intervention models from January 2015 to March 2017 in the first people's hospital of Yongkang city surgical treatment of bile duct carcinoma,40 cases of patients groups: control group with routine nursing plus saline intervention, observation group with psychological nursing + Tenai (parecoxib sodium) mode of intervention; on the psychological state of the two groups before and after intervention to improve patients the cognitive function, to improve the situation, changes in pain scores were recorded, and the related data for comparative analysis. Results The psychological nursing + Tenai (parecoxib sodium) model (observation group) intervention in the treatment of patients with bile duct cancer surgery clinical effect is better than that of routine nursing mode + normal saline (control group) the clinical effect of intervention, the psychological state of patients to improve the situation, improve cognitive function, pain score changes were better than the control group, there was statistical significant differences (P<0.05). Conclusion The surgical treatment of patients with cholangiocarcinoma patients psychological nursing + Tenai (parecoxib sodium) intervention effect significantly, can effectively improve the patients psychological status, cognitive function, and can reduce postoperative pain fully, has an excellent role in promoting the rehabilitation of patients after surgery, worthy of clinical application.
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Objective To study the clinical effect of parecoxib sodium for injection combined with psychological intervention on postoperative analgesia in the patients with thyroid cancer. Methods 100 patients with thyroid cancer Hangzhou tumor hospitalfrom July 2015 to April 2017 were randomly divided into two groups, the experimental group and the control group. The control group were given parecoxib sodium for injection, and the experimental group were received parecoxib sodium for injection combined with psychological intervention. Three days after treatment, the average amount of parecoxib sodium for injection and SAS, SDS score in the two groups were compared. Results The average dosage of parecoxib sodium for injection in the experimental group was (45.6±9.7) mg, and (67.9±9.5) mg in the control group. In the control group, SAS was (45.88± 7.56)points before treatment and (50.42±7.91) points after treatment, SAS was (45.94±7.32)points before treatment and (40.81 ± 6.61) points after treatment. SDS in the control group before treatment was (45.53±8.62) points and (50.29±7.24) points after treatment. In the experimental group, SDS before treatment was (45.41±7.18) points and (40.36±6.15) after treatment. The differences of all the data were statistically significant in the two gorups(P<0.01). Conclusion Postoperative psychological intervention can effectively enhance the analgesic effect of parecoxib sodium for injection, reduce the dosage and also improve the psychological score. This treatment is worthy of clinical promotion.
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Objective To investigate the clinical effect of different patient-controlled analgesia (PCA) modes in patients undergoing laparoscopic hysteromyomectomy.Methods Sixty patients scheduled for a laparoscopic hysteromyomectomy were randomly divided into three groups.All patients received an intravenous infusion of parecoxib sodium (40 mg) as preventive analgesia 15 min prior to the skin incision.Thirty minutes prior to the end of surgery,they received an intravenous injection of sufentanil (0.1 μg/kg) as a loading dose.The following data were collccted:the total dosage of sufentanil,the total and valid frequency of the PCA press,visual analog pain score,sedation score,the incidence of adverse reactions,the incidence of adverse reactions per group.Results Compared to groups 1 and 2,group 0 had the lowest dosage of sufentanil.There was no significant difference in the incidence of adverse reactions between the three groups (P ＞0.05).Conclusion The PCA-only mode,in conjunction with parecoxib sodium as preventive analgesia,was more suitable for patients undergoing laparoscopic hysteromyomectomy.
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Objective To investigate the effect of piracoxib sodium on analgesia in patients with upper abdominal surgery,and to provide a reference for the choice of analgesia in these patients.Methods A total of 120 patients with abdominal surgery (stomach,liver,pancreas,spleen,etc.) were enrolled using computer random software,including 81 males and 39 females,37-62 years old,BMI 17.6-24.2kg/m2,ASA grade Ⅰ-Ⅱ.They were randomly divided into parecoxib sodium group (P group) and control group (C group) using computer random software,60 patients in each group.The two groups were treated with midazolam 0.05mg/kg,propofol 1-1.5mg/kg,rocuronium 0.6mg/kg,sufentanil 0.6pg/kg for anesthesia induction.TCI propofol 2-4mg · kg-1 · h-1 and intermittent intravenous injection of sufentanil 0.1-0.2μg/kg,rocuronium 0.15-0.3mg/kg to maintain intraoperative BIS value between 40-60.The visual analogue scale (VAS) was recorded at 2h,4h,6h,8h and 12h after operation.The postoperative analgesia of sufentanil and PCIA bolus times were recorded at 12 hours postoperatively.The incidence of complications such as postoperative sleepiness,skin pruritus,postoperative nausea and vomiting (PONV) and other anesthesia-related complications were recorded.Results The VAS scores of the patients in the P group [(1.41 ± 0.29) points,(1.55 ±0.30) points] were significantly lower than those in the C group [(1.86 ±0.33) points,(1.95 ±0.41) points] both at static state and active state immediately out of the operation room (t =7.934,6.099,all P ＜ O.05).The dosage of sufentanil and the PCIA bolus times in the P group were significantly lower than those in the C group at 12 hours after operation (t =3.732,4.205,all P ＜ 0.05).The incidence rates of lethargy,PONV and skin pruritus in the P group were significantly lower than those in the C group (x2 =8.107,3.927,4.227,all P ＜ 0.05).Conclusion In the patients of upper abdominal surgery,the analgesic effect of parecoxib sodium can significantly reduce the dosage of sufentanil and reduce the risk of postoperative complications at the same time,it is worthy of promotion in clinical use.
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Objective To evaluate the safety of Parecoxib Sodium for Injection.Methods Systemic active anaphylaxis test:Guinea pigs were injected respectively with Parecoxib Sodium for Injection (test sample,20 mg/mL),primary control,sodium chloride injection or human serum albumin,once every other day,continuously for three times.After 14 and 21 d from the end time of sensitization,to stimulation and to observe whether allergic reactions occurred within 30 mins.Passive cutaneous anaphylaxis test:Guinea pigs were received 0.1 mL antiserum injection for inducing passive sensitization,after 24 h of that we stimulated the guinea pigs,and the guinea pigs were sacrificed after 30 mins to examine the diameter of blue spots.Blood vessel irritation test:After continuous ear Ⅳ test sample for 5 d,HE staining was performed at the end of the administration and recovery period,and the stimulation of the blood vessel at the site of injection was observed.Hemolysis or agglutination of Parecoxib Sodium for Injection was examined by in vitro methods.Results Under the dosage of 20 mg/mL,guinea pigs showed no systemic allergy and passive skin allergy,and no hemolysis,agglutination,and irritation of vascular was observed.Conclusion Under the present experimental conditions,20 mg/mL Parecoxib Sodium for Injection shows no obvious allergic reactions,irritation and hemolysis,is safe.
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Objective To evaluate the safety of Parecoxib Sodium for Injection.Methods Systemic active anaphylaxis test:Guinea pigs were injected respectively with Parecoxib Sodium for Injection (test sample,20 mg/mL),primary control,sodium chloride injection or human serum albumin,once every other day,continuously for three times.After 14 and 21 d from the end time of sensitization,to stimulation and to observe whether allergic reactions occurred within 30 mins.Passive cutaneous anaphylaxis test:Guinea pigs were received 0.1 mL antiserum injection for inducing passive sensitization,after 24 h of that we stimulated the guinea pigs,and the guinea pigs were sacrificed after 30 mins to examine the diameter of blue spots.Blood vessel irritation test:After continuous ear Ⅳ test sample for 5 d,HE staining was performed at the end of the administration and recovery period,and the stimulation of the blood vessel at the site of injection was observed.Hemolysis or agglutination of Parecoxib Sodium for Injection was examined by in vitro methods.Results Under the dosage of 20 mg/mL,guinea pigs showed no systemic allergy and passive skin allergy,and no hemolysis,agglutination,and irritation of vascular was observed.Conclusion Under the present experimental conditions,20 mg/mL Parecoxib Sodium for Injection shows no obvious allergic reactions,irritation and hemolysis,is safe.
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Objective To investigate the effects of ulinastatin with parecoxib sodium on early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement.Methods One hundred patients (aged 65-80 years,ASA grade Ⅱ) undergoing elective total hip replacement were randomly assigned into 4 groups: group W(n=25),group P(n=25),group WP(n=25) and group C(n=25).The patients in group W received intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation.Patients in group P accepted intravenous injection of parecoxib sodium of 40 mg before anesthesia and at a 12 h intervals for six times.Patients in group WP accepted intravenous injection of ulinastatin with a dose of 5 000 U/kg before skin incision and at the moment of the end of operation,and accepted intravenous injection of parecoxib sodium with a dose of 40 mg before anesthesia and at a 12 h interval for six times.Patients in group C were given normal saline at the same time as placebo.The operation time,the volume of bleeding and autologous blood receiving and the intraoperative fentanyl consumption were recorded in four groups.Blood samples were obtained before induction (T0),at the end of operation (T1),on 6 h (T2),24 h (T3),72 h (T4) after operation for determination of plasma concentration of S100β protein,neuron-specific enolase(NSE),IL-6,TNF-α.The percentages of T lymphocyte subsets (CD3+,CD4+,CD8+) and CD4+/CD8+ ratio were detected with flow cytometry.The Mini-Mental State Examination (MMSE) was used to test the cognitive function of the patients at T0,T4 and 7 d after operation (T5).Results Compared with T0,the percentages of CD3+,CD4+ cells and CD4+/CD8+ in groups C,W and P were significantly decreased,the plasma concentrations of IL-6 and TNF-α significantly increased at T1-T4,concentration of NSE and S100 protein were significantly increased at T2 and T3 (P<0.05).the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in groups W and P at T2,T3 and group WP at T1-T4 was significantly higher than that of group C,the concentration of IL-6,TNF-α,NSE and S100β protein content was significantly lower than in group C (P<0.05);the percentages of CD3+,CD4+T lymphocyte and CD4+/CD8+ ratio in group WP was significantly higher than those of groups W and P,the concentrations of TNF-α,IL-6,NSE and S100β protein content was significantly lower than those of group W and P at T2,T3 (P<0.05).Compared with T0,MMSE score in group C was significantly lower at T4,T5 (P<0.05).MMSE score of groups W,P and WP was significantly higher than that of group C at T4 (P<0.05).MMSE score of group WP was significantly higher than those of groups W and P at T4 (P<0.05).Conclusion Ulinastatin combined with parecoxib sodium ameliorates early cellular immunology function and cognitive function in elderly patients undergoing total hip replacement,and it is more effective than using ulinastatin or parecoxib sodium alone.
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Objective To explore the treatment of neuropathic pain,the combined use of parecoxib sodium after treatment based ontheuseoffentanyl on transparent paste.Methods In the period from August 2014 to August 2015 by the neuropathic pain patients in our hospital were selected in 38,they were divided intotwogroups,1groupsusingonlyfentanyltransparent paste treatment,2 group based on the use of fentanyl transparent paste on the combined use ofparecoxibsodium,comparingtwotreatmentsoftreatment effect.Results After five days,fifteen days and twenty-five days after treatment,the vas of the patients in the two groups was lower than that before the study,and there was a significant difference between the two groups(P<0.05).There is a big gap between the two groups(P<0.05).Conclusion Fentanyl transparent dressing in treating neuropathic pain can play an ideal therapeutic,for the use of a drug when the poor efficacy of the patient alone combined with parecoxib sodium can significantly improve the therapeutic effect.
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Objective To investigate the clinical preemptive analgesic efficacy of parecoxib sodium(PS) at different administration timing in the patients with total hip arthroplasty(THA).Methods Sixty patients receiving THA were prospectively enrolled and randomized into three groups.The group A started to be intravenously injected by PS 40mg/d on preoperative 3 d until operation day;the group B was intravenously injected by parecoxib sodium 40mg at preoperative 30 min;the group C began to be intravenously injected by the same dosage of normal saline at the same time point as the group A.The rest pain was assessed by using the visual analog scale(VAS) at postoperative 6,24,48,72 h.The duration of patient-controlled intravenous analgesia(PCIA) and total dosage were recorded.The first time unaided ambulation time was observed.Results The VAS scores at various postoperative time points in the group A and B were significantly lower than those in the group C(P＜0.05),the VAS scores at postoperative 6,24 h in the group A were remarkably lower than those in the group B.The PCIA duration in the group A,B and C were 25.05±10.32),(36.75± 13.91),(50.40 ± 15.17)h,respectively,the pair-wise comparison of the group A,B and C showed statistical difference(P＜0.05).The total dosages of PCIA drug in the group A,B and C were(29.25 ± 4.58),(34.50 ± 5.09),(62.65 ±10.52)tg,respectively,the dosage in the group A and B was significantly lower than that in the group C(P＜0.05).The first time unaided ambulation time in the group A,B and C were (2.75 ± 0.81),(3.05 ± 1.08),(4.10 ±-0.92)d respectively,which in the group A and B was earlier than that in the group C (P＜0.05).Conclusion Continuously using PS on preoperative 3 d can increase the analgesic effect in THA patients and is conducive to the functional rehabilitation and increase the patient satisfaction.
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OBJECTIVE:To investigate the effects of preemptive analgesia of parecoxib-sodium for radical mastectomy of breast cancer. METHODS:A total of 60 female patients underwent selective radical mastectomy of breast cancer under general anes-thesia were randomly divided into observation group(40 cases)and control group(20 cases). 15 min before anesthesia induction, observation group was given intravenous injection of Parecoxib-sodium for injection 40 mg. Control group was given intravenous in-jection of 0.9% Sodium chloride injection 5 mL. The pain visual analogue scale(VAS),the frequency of patient controlled intrave-nous analgesia(PCA)and ADR were observed between 2 groups at different time points after surgery. RESULTS:VAS scores of observation group were significantly lower than those of control group 2,4,6,8 h after operation,and the frequency of PCA 0-4, 4-12,12-24,24-36 h after operation was significantly lower than control group,with statistical significance(P0.05). CONCLUSIONS:The preemptive analgesia of parecoxib-sodium can effectively reduce pain degree of patients with breast cancer after radical mastectomy,the frequency of PCA, and do not increase the occurrence of ADR.