Effect of parecoxib sodium preemptive analgesia on postoperative cognition and inflammatory cytokines in elderly patients / 中国基层医药

ABSTRACT

Objective To study the effect of parecoxib sodium preemptive analgesia on the postoperative cognition and inflammatory cytokines in elderly patients.Methods Sixty elderly male patients undergoing replace-ment of total hip were randomly divided into two groupsthe control group(group C,30 cases) and the parecoxib sodi-um group(group P,30 cases).In group C,physiological saline 5 ml was injected after induction of anesthesia.Pare-coxib sodium 40 mg was injected after induction of anesthesia in group P.Peripheral venous blood was collected at the following time points2h before operation(T0 ),and 4h(T1 ),24h(T2 ) and 48h(T3 ) after operation.And the serum concentrations of IL -1β,IL -6,tumor necrosis factor α(TNF -α) were measured by enzyme linked immunosorbent assay(ELISA).Cognitive function was assessed by mini -mental state examination(MMSE) at the time of T0 -T3 . Results The MMSE scores in group P[(25.4 ±0.6) points,(27.2 ±0.1)points] were significantly higher than those in group C at T1 and T2 .The concentrations of IL -1β,IL -6 and TNF -αin group P[T1(18.43 ±4.45)pg/mL, (165.34 ±9.57)pg/mL,(34.43 ±3.83)pg/mL;T2(14.59 ±2.59)pg/mL,(98.99 ±7.28)pg/mL,(22.32 ± 3.81)pg/mL]were lower than those in group C[T1(23.97 ±3.85)pg/mL,(204.19 ±12.44)pg/mL,(37.77 ± 4.81)pg/mL;T2(19.33 ±3.18)pg/mL,(121.35 ±9.67)pg/mL,(29.01 ±3.39)pg/mL]at T1 ,T2 .The concen-trations of IL -1β,IL -6 and TNF -αand the MMSE scores had no differences in group P and group C at T3 .The concentrations of IL -1β,IL -6 and TNF -αin group P at T1 and T2 [(9.57 ±2.24)pg/mL,(46.15 ±6.18)pg/mL, (14.48 ±3.14)pg/mL] were lower than those at T0,and had no difference at T3 .Conclusion Parecoxib sodium preemptive can reduce the incidence of POCD in elderly patients by inhibiting the release of early postoperative pro -inflammatory cytokines.