Efficacy and safety of parecoxib versus ketorolac tromethamine for perioperative analgesia：a systematic review / 中国药房

OBJECTIVE To compare the efficacy and safety of parecoxib and ketorolac tromethamine for perioperative analgesia， and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， VIP， Wanfang Data， Baidu and Google， randomized controlled trials （RCT） about parecoxib （trial group） versus ketorolac tromethamine （control group） for perioperative analgesia were collected from the inception to Jun. 17th， 2022. After screening the literature and extracting the data， the quality of the included literature was evaluated using the bias risk assessment tool recommended by Cochrane system evaluator manual 5.1.0. Meta-analysis， sensitivity analysis and publication bias analysis were performed with RevMan 5.4 software. RESULTS A total of 12 RCTs were included， with 1 118 patients. Meta- analysis results showed that at the time of administration before anesthesia induction， there was no statistically significant difference between the 2 groups in visual analogue scale （VAS） [MD＝－0.16， 95%CI （－0.41， 0.09）， P＝0.20]， numerical rating scale （NRS） [MD＝0.01， 95%CI （－0.36， 0.38）， P＝0.97]， postoperative bleeding [MD＝0.15， 95%CI （－0.63， 0.93）， P＝0.71]， and consumption of opioid analgesics [MD＝0.12， 95%CI （－0.77， 1.01）， P＝0.79]. At the time of postoperative administration， VAS and bleeding volume at 48 h after operation of trial group were significantly lower than control group （P＜0.05）. The results of subgroup analysis by different com assessment time points showed that the VAS of patients in trial group at 0 h after operation were significantly lower than control group at the time of administration before anesthesia induction； at the time of postoperative administration， VAS of patients in the trial group at 12 h and 48 h after operation were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups [RR＝0.93，95%CI （0.78，1.11），P＝0.43]. The results of subgroup analysis according to different types of adverse reactions showed that the incidence of nausea and vomiting of trial group was significantly lower than control group， and the incidence of other adverse reactions was significantly higher than control group （P＜0.05）. Results of sensitivity analysis showed that study results were stable and reliable. Results of publication bias analysis showed that there was great possibility of publication bias in this study. CONCLUSIONS The efficacy of parecoxib is equivalent to that of ketorolac tromethamine for perioperative analgesia before operation； at the time of administration after operation， parecoxib has better analgesic effect and less postoperative bleeding； the incidence of nausea and vomiting caused by parecoxib is lower at any time of administration.

Meta-analysis of the effectiveness and safety of parecoxib sodium for gynecological surgery and postoperative analgesia / 中国药房

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.

Clinical observation of inferior alveolar nerve block combined with parecoxib sodium intravenous analgesia after mandible orthognaxillary surgery / 口腔疾病防治

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.

Efficacy of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative analgesia in patients undergoing pancreaticoduodenectomy / 南方医科大学学报

OBJECTIVE@#To explore the effect of local infiltration of ropivacaine combined with multimodal analgesia with parecoxib for perioperative pain management in patients undergoing pancreaticoduodenectomy.@*METHODS@#This randomized controlled trial was conducted among 98 patients undergoing pancreaticoduodenectomy in the Department of Biliary Surgery of West China Hospital between March, 2017 and August, 2018. The patients were randomized to receive perioperative analgesia with local infiltration anesthesia with ropivacaine combined with multimodal analgesia with parecoxib (experimental group, =50) or postoperative analgesia with dizosin (control group, =48). The regimens for intraoperative anesthesia and postoperative pain relief were identical in the two groups. The differences in NRS pain score, use of pain relief agents, the incidences of adverse reactions to analgesia and wound infection, and the time to first ambulation and first flatus passage after the operation were compared between the two groups.@*RESULTS@#At 12, 24 h, 48 h, 72 h and 7 days after the operation, the patients in the experimental group had significantly lower NRS scores ( < 0.05) than those in the control group. The rate of use of rescue analgesics was significantly lower in the experimental group than in the control group (32% 66.67%, < 0.05); the rate of tramadol hydrochloride use was also significantly lower in the experimental group ( < 0.05). Compared with those in the control group, the patients in the experimental group showed a significantly lower total incidence of adverse reactions (22% 54.17%, < 0.05) as well as a lower incidence of nausea and vomiting ( < 0.05), an earlier time of first ambulation and first flatus passage after the operation ( < 0.05), and a shorter postoperative hospital stay ( < 0.05).@*CONCLUSIONS@#In patients undergoing pancreaticoduodenectomy, local infiltration of ropivacaine combined with multimodal analgesia with ropivacaine can effectively relieve perioperative pain, reduce the use of relief analgesics, lower the incidence of adverse reactions, and promote the recovery after the surgery.

Clinical efficacy of intra-articular parecoxib injection for the treatment of early knee osteoarthritis / 中国骨伤

OBJECTIVE@#To observe and evaluate the clinical effect of intra-articular injection of parecoxib in patients with early knee osteoarthritis.@*METHODS@#From September 2016 to August 2017, 107 patients with early knee osteoarthritis were treated, including 50 males and 57 females, aged 45 to 64 (51.9±4.2) years. They were divided into basic therapy+oral glucosamine group(group A) 36 cases, oral celecoxib+basic therapy+oral glucosamine group(group B) 36 cases, intra-articular injection of parecoxib+basic therapy+oral glucosamine group(group C) 35 cases. There was no significant difference in gender, age, BMI and clinical stage(Kellgren-Lawrence classification) between the three groups before treatment. VAS score, HSS score and patient satisfaction were compared before and after treatment in the three groups. The levels of inflammatory cytokines in synovial fluid were measured before and after treatment in the three groups.@*RESULTS@#All cases were followed up for(15.2±2.6) months on average. The VAS score and HSS score of each group were improved after treatment(<0.001). There were significant differences in VAS and HSS scores among the three groups after treatment(<0.001). The clinical efficacy of group C was better than that of group A and B(<0.001), group B was better than that of group A(<0.001), and group C had the highest satisfaction(<0.001). After treatment, the concentration of proinflammatory factor TNF-α and IL-6 in the synovial fluid of each group decreased(<0.001) and the concentration of anti-inflammatory factor IL-10 increased(<0.001). After treatment, the concentrations of TNF-α, IL-6 and IL-10 in the synovial fluid of the three groups were significantly different(<0.001).@*CONCLUSIONS@#For patients with early knee osteoarthritis, intra-articular injection of parecoxib can significantly improve clinical symptoms and avoid adverse reactions of long-term oral NSAIDs, which is an effective treatment.

Effect and safety of dexmedetomidine and parecoxib sodium alone or in double combinations in improving restlessness in recovery period in patients undergoing thoracic surgery / 新乡医学院学报

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.

Effects of preoperative use of parecoxib sodium on perioperative pain and coagulation in patients with epidural hematoma / 中国基层医药

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.

Effect and Safety of Paracoxib Sodium on Preemptive Analgesia by Endoscopic Submucosal Dissection / 医药导报

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.

Effect of intrathecal parecoxib sodium in bone tumor pain of rats / 中国医师进修杂志

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.

Postoperative analgesic effect of parecoxib in combination with incision infiltration by local anesthetics after laparoscopic inguinal hernia repair / 中华普通外科杂志

Objective To investigate the postoperative analgesic effect of parecoxib following laparoscopic inguinal hernia repair when local anesthetics was infiltrated at incision site.Methods 160 patients were divided into four groups (40 in each group).Group A received intravenous 4 ml saline and incision infiltration with saline in ten minutes before thc end of operation.Group B received intravenous parecoxib 40 mg and incision infiltration with saline.Group C received intravenous 4 ml saline and incision infiltration with 0.75％ ropivacaine.Group D received intravenous parecoxib 40 mg and incision infiltration with 0.75％ ropivacaine.Results There was no significant difference between group A and group C of the VAS scores at 6 hours,while the VAS values in group D was significantly lower than group A,B and C (P ＜ 0.05).There was no significant difference among group A,B and C in VAS at 24 hours (P ＞ 0.05),while VAS in group D was significantly lower than others (P ＜ 0.05).The satisfactory rate with analgesia in group D (95％) was significantly higher than other three groups (P ＜ 0.05).Conclusions Paricoxib combined with local anesthetics infiltration can significantly relieve the pain at postoperative early stage in patients receiving laparoscopic inguinal hernia repair.

Effect of parecoxib sodium on serum surfactant protein A and inflammatory response in elderly patients undergoing video-assisted thoracoscopic pneumonectomy / 临床麻醉学杂志

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.

Acupuncture combined with local anesthesia for percutaneous vertebroplasty / 中国针灸

<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>

Analgesic drugs for patients with non-small cell lung cancer undergoing video-assisted thoracic surgery lobectomy: A randomized controlled trial / 中国胸心血管外科临床杂志

@#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.

Observation of Dezocine Combined with Parecoxib on Prevention of Emergence Pain and Agitation in Pa-tients Undergoing Radical Hysterectomy / 中国药师

Objective:To compare the preventive effects of dezocine or parecoxib used alone or combination on emergence pain and agitation in the patients undergoing radical hysterectomy. Methods: Sixty ASA Ⅰ~Ⅱ patients undergoing radical hysterectomy were randomly divided into three groups. At the time of sewing incision, the dezocine group (group D, n=20) received dezocine in-travenous injection at the dosage of 0. 1 mg·kg-1, the parecoxib group (group P, n=20) received parecoxib intravenous injection at the dosage of 0.8 mg·kg-1, and the combination group (group DP, n=20) received 0.1 mg·kg-1dezocine and 0.8 mg·kg-1 parecoxib. When the operation was finished, the patients were transferred to the recovery room with endotracheal tubes, and recovered and extubated without the administration of reversal agents. Visual analogue scale ( VAS) for pain and Aono' s four-point scale for e-mergence agitation ( EA) were measured. The recovery time, extubation time, VAS, degree of EA and side effects such as nausea, vomiting, respiratory depression and hypersomnia during the emergence were also evaluated and recorded. Results:There were no sig-nificant differences in recovery time and extubation time among the three groups (P >0. 05). The VAS score and degree of EA in group DP were lower than that in group D (4. 65 ± 1. 69) and group P (5. 95 ± 1. 82) (P0. 05), and no side effects such as nausea, vomiting, respiratory depression and hypersomnia were detected during the emergence. Conclusion:Intravenous injection of 0. 1 mg·kg-1 dezocine combined with 0. 8 mg·kg-1 parecoxib at the time of sewing incision shows effective analgesia and emergence agitation reduction without obvious complications in the patients undergoing radical hysterecto-my.

Perioperative intravenous Parecoxib for pain management after laparoscopic colorectal cancer surgery / 中华普通外科杂志

Objective To investigate the analgesic effect of perioperatively intravenous Parecoxib for pain management after laparoscopic surgery of colorectal cancer,and whether it can reduce opioid requirements and opioid-related adverse effects.Methods 116 patients ungergoing laparoscopic colorectal resection were randomized to receive either intravenous parecoxib at a dose of 40 mg 15 minutes before induction of anesthesia followed by 40 mg every 12 hous for 72 hours (Parecoxib Group,n =59) or without the use of Parecoxib (control group,n =57).All patients had access to patient controlled analgesia (PCA) with Sufentanil within 48 hours after the operation.Patients were assessed with respect to Visual Analog Scale (VAS) from 0-10,and supplementary opiates were provided when VAS was above 4.Results Compared with control group,Parecoxib group had lower VAS scores at rest,while coughing and mobilization at each time point after the operation (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).The postoperative hospital stay was less in Parecoxib group (P ＜0.05),and Parecoxib group consumed less opium on post-op day 1 [0 mg(0,7.5) vs.10 mg(7.5,15),Z=2 364,P =0.000],and less total opium consumption in 5 days after surgery [20 mg (10,25) vs.42.5 mg (37.5,45),Z =1 770,P =0.000].Conclusions The use of Parecoxib with PCA Sufentanil in postoperative analgesia resulted in comprehensive enhancement of the analgesic efficacy,reducing the opioid requirement,promoting postoperative recovery and shortening hospital stay.

Effect of advanced analgesia with parecoxib sodium on the dosage of sufentanil for postoperative analgesia in patients underwent upper abdominal surgery / 中国基层医药

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.

Safety evaluation of Parecoxib Sodium for Injection / 药物评价研究

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.

Safety evaluation of Parecoxib Sodium for Injection / 药物评价研究

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.

Preemptive analgesic effect of administration timing of parecoxib sodium in patients with total hip arthroplasty / 重庆医学

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.

Effects Observation of Preemptive Analgesia of Parecoxib-sodium for Radical Mastectomy of Breast Cancer / 中国药房

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.