Effect of multimodal analgesia with diclofenac sodium on cognitive function following radical resec-tion for colon cancer in elderly patients / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the effect of multimodal analgesia with diclofenac sodium on cognitive function following radical resection for colon cancer in elderly patients. Methods Sixty American Society of Anesthesiologists physical statusⅠorⅡpatients of either sex, aged 65-80 yr, weighing 45-85 kg, scheduled for elective open sigmoidectomy under general anesthesia, were divided into control group and test group by a random number table method with 30 patients in each group. In test group, diclofenac sodium suppository was administrated rectally before surgery and placed at about 2 to 3 cm above the anal dentate line, diclofenac sodium suppository 50 mg was given at 2 h before surgery and 4 h after surgery, followed by administration once every 12 h until 2 days after surgery. Patient-controlled intravenous analge-sia was performed after operation, dezocine 5 mg was intravenously injected when VAS score was more than 4 points within 48 h after surgery. The concentrations of serum interleukin-6 ( IL-6) , IL-8 and tumor nec-rosis factor-alpha ( TNF-α) were measured by enzyme-linked immunosorbent assay before surgery ( T0 ) and at 2, 6, 12, 24 and 48 h after surgery ( T1-5 ) . The postoperative requirement for rescue analgesia, post-operative analgesia satisfaction score, time of passing the first flatus and first postoperative off-bed time were recorded. Cognitive function was assessed at 1 day before surgery and 7 days after surgery, and the occur-rence of postoperative cognitive dysfunction was recorded. Results Compared with control group, the ser-um concentrations of IL-6 at T2-5 , IL-8 at T1-5 and TNF-αat T2-4 were significantly decreased, the require-ment for rescue analgesia and incidence of postoperative cognitive dysfunction were decreased, and the timeof passing the first flatus and first postoperative off-bed time were shortened in test group ( P<0. 05) . Con-clusion Diclofenac sodium for multimodal analgesia can improve cognitive function following radical resec-tion for colon cancer in elderly patients.