Parecoxib sodium attenuates acute lung injury following burns by regulating M1/M2 macrophage polarization through the TLR4/NF-κB pathway.

High temperature-induced burn injury often leads to an excessive inflammatory cascade resulting in multiple organ dysfunction syndrome, such as acute lung injury (ALI), in addition to skin tissue damage. As a specific COX2 inhibitor, parecoxib sodium suppresses the inflammatory response during burn injury. The effect of parecoxib sodium on ALI induced by burn injury and the associated molecular mechanism still need to be investigated. The role of parecoxib sodium in burn injury-induced ALI through the TLR4/NF-κB pathway was explored in the present study. A burn-induced ALI mouse model was constructed, and M1/M2 macrophages in lung tissue and markers involved in the TLR4/NF-κB signalling pathway were evaluated in bronchoalveolar lavage fluid (BALF) and MH-S mouse alveolar macrophages in vitro. The results indicated that parecoxib sodium attenuated lung injury after burn injury, decreased iNOS and TNF-α expression, increased IL-10 expression in BALF, and regulated the CD86-and CD206-mediated polarization of M1/M2 macrophages in lung tissue along with MH-S mouse alveolar macrophages. The effect of parecoxib sodium might be reversed by a TLR4 agonist. Overall, the results suggested that parecoxib sodium can regulate the polarization of M1/M2 macrophages through the TLR4/NF-κB pathway to attenuate ALI induced by skin burns.

The effect of parecoxib sodium on postoperative delirium in elderly patients with hip arthroplasty.

Objective: This study aimed to clarify the effect of parecoxib sodium on the occurrence of postoperative delirium and to investigate its possible mechanism. Methods: A total of 80 patients who underwent elective hip arthroplasty in our hospital between December 2020 and December 2021 were selected and randomly divided into two groups: a parecoxib sodium group (group P, n = 40) and a control group (group C, n = 40). Patients in group P were intravenously injected with 40 mg of parecoxib sodium 30 min before anesthesia and at the end of the surgery. Patients in group C were intravenously injected with the same volume of normal saline at the same time points. The primary endpoint was the incidence of POD, and the secondary endpoints were the levels of inflammatory factors (tumor necrosis factor- α [TNF-α], interleukin [IL]-1ß, IL-6, and IL-10), nerve injury-related factors (brain-derived neurotrophic factor [BDNF], S-100ß protein, neuron-specific enolase [NSE], and neurofilament light chain [NfL]), and antioxidant factors (heme oxygenase-1 [HO-1]), as well as the Visual Analogue Scale (VAS) and Confusion Assessment Method-Chinese Reversion (CAM-CR) scores. Results: The incidence of POD was 10% in group P and 27.5% in group C. Intergroup comparison revealed that the levels of TNF-α, IL-1ß, S-100ß, NfL, and NSE were lower, and BDNF was higher, in group P than in group C at each postoperative time point. The levels of IL-6 were lower, and the levels of IL-10 and HO-1 were higher, in group P than in group C at 1 h and 1 day postoperatively (p < 0.05). Three days after surgery, the differences in the levels of IL-6, IL-10, and HO-1 were not statistically significant between the two groups (p > 0.05). The VAS and CAM-CR scores were lower at each postoperative time point in group P than in group C (p < 0.05). Conclusion: Parecoxib sodium could reduce postoperative pain, decrease the plasma levels of inflammatory and nerve injury-related factors, upregulate HO-1 levels, and reduce the incidence of POD. The results of this study suggest that parecoxib sodium may reduce the occurrence of POD through the effects of anti-inflammation, analgesia, and antioxidants.

Sufentanil combined with parecoxib sodium inhibits proliferation and metastasis of HER2-positive breast cancer cells and regulates epithelial-mesenchymal transition.

BACKGROUND: Sufentanil combined with parecoxib sodium is a commonly used postoperative medication for cancer patients. However, the effects of this combination therapy on human epidermal growth factor receptor-2 (HER2)-positive breast cancer cells have still remained elusive. This study aimed to investigate the effects and potential mechanisms of sufentanil combined with parecoxib sodium on HER2-positive breast cancer cells. METHODS: The cell counting kit-8 (CCK-8), colony formation, flow cytometry, scratch, transwell invasion, and angiogenesis assays were used to assess the proliferation, cell cycling, migration, invasion, and angiogenesis of HER2-positive breast cancer BT474 cells. Western blot assay was employed for detecting the expression levels of proteins involved in the cell cycle, migration, invasion, angiogenesis, and epithelial-mesenchymal transition (EMT). The in vivo effects of tumor growth and metastasis were examined by establishing an orthotopic transplantation mouse model of HER2-positive breast cancer (MMTV-PyMT). RESULTS: Functional assays indicated that sufentanil combined with parecoxib sodium induced blockade of HER2-positive breast cancer BT474 cells in the G1 phase of the cell cycle and inhibited cell proliferation, migration, angiogenesis, and invasion in vitro. Western blot assay revealed that sufentanil combined with parecoxib sodium downregulated the expression levels of cyclin D1, matrix metalloproteinase-9 (MMP-9), cyclooxygenase-2 (COX-2), vascular endothelial growth factor A (VEGFA), and EMT-related proteins (N-cadherin, Vimentin, and Snail), while up-regulated the expression level of E-cadherin in BT474 cells. In addition, it was found that sufentanil combined with parecoxib sodium inhibited tumor growth and metastasis in the orthotopic transplantation mouse model of HER2-positive breast cancer. CONCLUSION: Sufentanil combined with parecoxib sodium inhibited HER2-positive breast cancer progression, including cell proliferation, cell cycle, migration, invasion, and angiogenesis, and regulated EMT.

Inhibition effect of choline and parecoxib sodium on chronic constriction nerve injury-induced neuropathic pain in rats.

PURPOSE: The simultaneous use of drugs with different mechanisms of analgesic action is a strategy for achieving effective pain control while minimizing dose-related side effects. Choline was described to potentiate the analgesic action of parecoxib sodium at small doses in several inflammatory pain models. However, these findings are still very limited, and more associated data are required to confirm the effectiveness of the combined choline and parecoxib sodium therapy against inflammatory pain. METHODS: Adult rats were randomly divided into 9 groups (N = 6/group). The sham surgery group received an intraperitoneal (i.p.) injection of saline. Rats with chronic constriction injury (CCI) of the sciatic nerve received saline, choline (cho, 6, 12 and 24 mg/kg), parecoxib sodium (pare, 3, 6, and 12 mg/kg), or a combination of choline 6 mg/kg and parecoxib sodium 3 mg/kg. Mechanical and heat pain thresholds were measured at 30 min after drug treatment at Days 3, 5, 7, 10, and 14 after CCI. Another 30 rats were divided into 5 groups (N = 6/group): the sham, CCI + saline, CCI + cho-6 mg/kg, CCI + pare-3 mg/kg, and CCI + cho-6 mg/kg + pare-3 mg/kg groups. After repeated drug treatment for 7 days, five rats were randomly selected from each group, and the lumbar dorsal root ganglia (DRGs) (L4-6) were harvested for western blot analysis. RESULTS: Choline significantly attenuated mechanical and heat hypersensitivity in CCI rats at 12 and 24 mg/kg doses (P < 0.05) but was not effective at the 6 mg/kg dose. Parecoxib sodium exerted significant pain inhibitory effects at the 6 and 12 mg/kg doses (P < 0.05) but not at the 3 mg/kg dose. Combining a low dose of choline (6 mg/kg) and parecoxib sodium (3 mg/kg) produced significant pain inhibition in CCI rats and reduced the expression of high mobility group protein 1 (HMGB1) and nuclear factor-kappa Bp65 (NF-κBp65) in L4-6 DRGs. CONCLUSION: 1. In a rat model of chronic neuropathic pain (CCI), at a certain dose, choline or parecoxib sodium can alleviate mechanical pain and thermal hyperalgesia caused by CCI. 2. The combination of choline and parecoxib sodium in nonanalgesic doses can effectively relieve neuropathic pain, and its mechanism may be related to the inhibition of the high mobility group protein 1 (HMGB1)/Toll-like receptor 4 (TLR4)/nuclear factor kappa-B (NF-κB) pathway.

Effects of Parecoxib Sodium Application Combined with Enhanced Recovery After Surgery Nursing on Inflammatory Factors and Knee Joint Function in Elderly Patients After Total Knee Arthroplasty.

Objectives: To study the effect of parecoxib sodium (PS) application, combined with enhanced recovery after surgery (ERAS) nursing, on inflammation and knee joint function in elderly patients after total knee arthroplasty (TKA). Methods: In this prospective cross-sectional study, we recruited 120 elderly patients treated with TKA who were randomly divided into two groups, the combine group and the control group, with 60 patients in each group. Patients in the control group received ERAS nursing and normal saline, and the patients in the combine group received ERAS nursing and PS. At different times after surgery, we compared the hemoglobin (Hb), complete white blood cell count (WBC), erythrocyte sedimentation rate (ESR), and serum IL-1ß, TNF-α, and IL-6, and recovery time for different ranges of joint motion and the knee joint function HSS (hospital for special surgery scale) score between the two groups. Results: On the third and seventh postoperative days, the levels of Hb in the patients of the combine group were significantly lower than those in the control group (p < 0.05), while the levels of WBC, ESR, serum IL-1ß, TNF-α, and IL-6 in the patients of the combine group were all significantly lower than those in the control group (p < 0.05). Compared with the patients in the control group, the recovery time for 30, 60, 90, and 120 angles of joint motion in patients of the combine group was significantly decreased (p < 0.05), and the HSS score of patients in the combine group was significantly higher than that in the control group on the first, third, and sixth postoperative months (p < 0.05). Conclusion: Elderly TKA patients who received PS application, combined with ERAS nursing, had lower inflammation in peripheral blood 2 weeks after operation and faster postoperative recovery of knee joint function.

Acupressure versus parecoxib sodium in acute renal colic: A prospective cohort study.

Background: Here provides a complementary treatment, acupressure at the Qiu acupoint, a novel acupoint, which potentially alleviates renal colic. Materials and methods: 90 patients were included in this study. Acupressure-group patients (n = 46) were administered acupressure at the Qiu acupoint following a preset protocol. Parecoxib sodium-group patients (n = 44) were administered parecoxib sodium (40 mg) (via the direct intravenous route). The visual analog scale (VAS) was used to evaluate pain intensity at baseline and at 1, 5, 10, 20, 30, and 120 min after initiating the intervention. Linear mixed effects model was performed to detect the rate of decrease of VAS per time and their covariant effect on the efficacy of acupressure. Results: No significant statistical differences in baseline data and VAS scores were observed. The acupressure group obtained lower VAS scores at the 1st, 5th, 10th, and 20th minute than the parecoxib sodium group after initiating the intervention (mean: 4.33 vs. 7.61, mean difference (MD): 3.29, 95% CI: 0.23, 2.84; mean: 2.65 vs. 7.61, MD: 4.96, 95% CI: 4.44, 5.49; mean: 1.63 vs. 6.59, MD: 4.96, 95% CI: 4.48, 5.44; mean: 1.26 vs. 3.64 MD: 2.38, 95% CI: 1.87, 2.88; P < 0.05). The markedly effective rate was similar between the two groups. The linear mixed effects model demonstrated that acupressure at the Qiu point was significantly faster than parecoxib sodium in decreasing VAS scores with an estimate of -2.05 (95% CI: -2.51, -1.59, p = 0.000), especially within 10 minutes with an estimate of 0.18 (95% CI: 0.12, 0.25, p = 0.000). Conclusion: Acupressure at the Qiu acupoint is significantly faster than parecoxib sodium in decreasing VAS scores within 10 minutes. Clinical trial registration: http://www.chictr.org.cn/, identifier 2100047168.

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.

Postoperative analgesic effect of parecoxib sodium local anesthesia in patients with breast cancer through systematic review and meta-analysis.

BACKGROUND: Postoperative pain can seriously affect a patient's recovery, and parecoxib sodium has a good analgesic effect. However, there is a lack of clinically systematic analyses of the effects of parecoxib sodium on postoperative pain in breast cancer patients. The aim of the present study was to systematically evaluate the efficacy and safety of parecoxib sodium local anesthesia in the treatment of postoperative pain in breast cancer patients. METHODS: Literature published from January 2010 to December 2020 was searched in the China National Knowledge Infrastructure database, Wanfang database, PubMed, and Cochrane Library. Literature on randomized controlled trials of parecoxib sodium local anesthesia in patients with breast cancer was collected. Method of treatment was extracted and literature quality was assessed. Meta-analyses of included literature were performed using RevMan 5.3. RESULTS: A total of 17 randomized controlled trials were included, with a total of 1,032 breast cancer surgery patients. The experimental group was treated with parecoxib sodium anesthesia, and the control group was treated with other anesthesia methods. The meta-analysis results showed that there were obvious differences among visual analogue scale (VAS) score of the experimental group and control group 2 h after surgery [mean difference (MD): -0.79; 95% confidence interval (CI): -1.29 to -0.29; P=0.002], 4 h (MD =-0.77; 95% CI: =-1.51 to -0.03; P=0.04), 6 h (MD: -1.10; 95% CI: -1.41 to -0.80; P<0.00001), 8 h (MD: -0.66; 95% CI: -1.00 to -0.33; P=0.0001), 12 h (MD: -0.92; 95% CI: -1.24 to -0.60; P<0.00001), 24 h (MD: -0.86; 95% CI: -1.15 to -0.58; P<0.00001), and 48 h (MD: -0.90; 95% CI: -1.47 to -0.33; P=0.002). Moreover, visual analog scale score and the postoperative controlled analgesia frequency of patients in the experimental group (MD: -2.08; 95% CI: -2.88 to -1.27; P<0.00001) and the incidence of adverse reactions (odds ratio: 0.52; 95% CI: 0.34-0.80; P=0.002) were significantly reduced. DISCUSSION: Parecoxib sodium local anesthesia for breast cancer patients has good postoperative analgesia and treatment safety.

Protective effect of parecoxib sodium against ischemia reperfusion­induced intestinal injury.

Ischemia reperfusion (I/R)­induced intestinal injury is a pathophysiological process leading to oxidative stress and inflammatory responses, and revealing its underlying mechanisms is essential for developing therapeutic strategies. Cyclooxygenase (COX) has been reported to be involved in I/R injury. Parecoxib sodium, a selective inhibitor for COX­2, exerts protective effects, such as reducing I/R­induced injuries in the heart, kidney and brain. However, the potential role of parecoxib sodium in protecting the small intestine against I/R­induced injury has rarely been investigated. Therefore, the aim of the present study was to elucidate the effects and potential mechanisms of parecoxib sodium in I/R­induced intestinal injury. In total, 60 Sprague­Dawley rats were randomly divided into four groups: Control (sham operation) group, intestinal I/R group, 10 mg/kg parecoxib sodium­pre­treated I/R (I/R + Pare/10) group and the 20 mg/kg parecoxib sodium­pre­treated I/R (I/R + Pare/20) group. A regular I/R model was established to induce the intestinal injury in rats. Parecoxib sodium at 10 or 20 mg/kg was intraperitoneally administered into rats in both I/R + Pare groups once daily for 5 consecutive days prior to ischemia. Blood samples and small intestinal tissues were collected at 2 h after reperfusion. Changes in the levels of malondialdehyde, nitric oxide, interleukin (IL)­1ß, IL­8, intercellular cell adhesion molecule­1 and IL­10, as well as the total antioxidant capacity were determined using ELISA, as were the activities of superoxidase dismutase and myeloperoxidase. Furthermore, the protein expression levels of total caspase­3, cleaved caspase­3, Bcl­2 and Bax were examined via western blot analysis. In addition, the daily survival rate post­reperfusion was examined for 7 days. It was revealed that parecoxib sodium increased the levels of antioxidants and suppressed the intestinal oxidative injury induced by I/R. Moreover, parecoxib sodium downregulated the expression levels of the proinflammatory factors, but upregulated the expression levels of anti­inflammatory factors. The results also demonstrated that parecoxib sodium attenuated I/R­induced apoptosis and increased the survival rate of rats. Thus, administration of parecoxib sodium prior to intestinal I/R attenuated intestinal injury and increased the rat survival rate by inhibiting I/R­induced inflammation, oxidative stress and apoptosis.

Perioperative analgesia with parecoxib sodium improves postoperative pain and immune function in patients undergoing hepatectomy for hepatocellular carcinoma.

RATIONALE, AIMS, AND OBJECTIVES: Acute postoperative pain can result in immune dysfunction, which can be partly mitigated by efficient pain management. Opioids that have been widely applied to analgesia have been shown to suppress immune function, which has a negative impact on the treatment of patients with cancer. This study investigated the effects of perioperative fentanyl analgesia alone or in combination with parecoxib sodium on postoperative pain, immune function, and prognosis in patients undergoing hepatectomy of hepatocellular carcinoma (HCC). METHODS: A total of 80 patients scheduled for hepatectomy between October 2013 and August 2014 were included. Patients were randomly divided into two groups (n = 40) and allocated to receive parecoxibsodium 40 mg (group P) or placebo (group C) 30 minutes before induction of anaesthesia, followed by 40 mg every 12 hours for 48 hours after the operation. All patients had access to patient-controlled analgesia with intravenous fentanylpostoperatively. Venous blood samples were collected at the following time points: 30 minutes before induction of anaesthesia (T0), the end of the surgery (T1), 24 hours after surgery (T2), and 72 hours after surgery (T3). The percentages of CD3+, CD4+, CD8+, CD4+/CD8+ T cells, and CD3+CD16+CD56+ (NK) cells at these time points were quantified by flow cytometry (FCM).Visual analogue scale (VAS) scores, total fentanyl consumption, and adverse effects were recorded. The prognostic differences in overall survival (OS) and disease-free survival (DFS) between the two groups was also investigated. RESULTS: For both groups, the percentages of CD3+, CD4+ T cells, and the ratio of CD4+/CD8+ significantly decreased at T1 and T2 (P < .05). The percentages of CD3+ T cells were significantly lower in group C than that in group P at T2 (P < .05). In group C, the amount of CD3+ T cells was lower at T3 compared with T0 (P < .05). The percentages of NK cells significantly decreased at T1 in both groups (P < .05). The percentages of NK in group P were recovered nearly to baseline (T0) at T2, which was higher than that of group C (P < .05). In group C, the percentages of NK cells have not recovered nearly to baseline at T3 compared with T0 (P < .05). VAS scores at rest and on cough in group P were significantly lower than those in group C at 2, 6, 12, and 24 hours after operation (P < .05), and there were no significant differences in VAS scores between the two groups at 48 hours after surgery (P > .05). There were no significant differences regarding the incidence of adverse effects between the two groups (P > .05). Kaplan-Meier analysis indicated that the DFS time in group P was significantly longer than in group C (19.0 months, 95% confidence interval [CI], 9.8-28.2 vs 14.0 months, 95% CI, 8.1-19.9; P < .05). There was no significant difference in OS time (36.0 months, 95% CI, 13.4-58.9 vs 14.0 months, 95% CI, 10.6-25.4; P > .05) between two groups. CONCLUSIONS: The present study indicated that perioperative analgesia of parecoxib sodium combined with patient-controlled analgesic fentanyl resulted in better preserved immune function with enhancement of the analgesic efficacy to fentanyl alone of HCC patients undergoing hepatectomy and helped postpone postoperative tumour recurrence.

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.

Parecoxib Shortens the Duration of Acute Postoperative Pain After Laparoscopic-Assisted Vaginal Hysterectomy.

The effect of parecoxib sodium on the duration and severity of acute postoperative pain after laparoscopic-assisted vaginal hysterectomy has been inadequately studied. This randomized, controlled trial compared the effects of parecoxib, methylprednisolone, and placebo on the duration of acute postoperative pain after elective laparoscopic-assisted vaginal hysterectomy. Ninety-four eligible patients were randomized to three groups [parecoxib sodium 40 mg (Group P), methylprednisolone 1 mg/kg (Group M), and saline (Group S)]. The duration of pain during coughing [median (interquartile range)] was significantly lower in Group P than in Group M or Group S [26.0 (5.8-48.0) vs. 48.0 (30.0-55.5) vs. 48.0 (36.0-58.5) h; p = 0.025]. The duration of pain during rest was also significantly lower in Group P than in Group M or Group S [5.5 (3.8-21.0) vs. 24.0 (6.0-28.0) vs. 22.0 (5.8-36.0) h; p = 0.009]. Compared with those in Group M and Group S, the patients in Group P reported less intense visceral pain during coughing at 12 (p = 0.050) and 24 h (p = 0.009) as well as at rest at 12 h (p = 0.008). Compared with those in Group P and Group S, the patients in Group M showed lower serum C-reactive protein levels and higher blood glucose levels after surgery. No differences were noted in nausea, vomiting, length of hospital stay, wound infection, and delayed wound healing among the groups. Thus, parecoxib sodium reduces the duration and intensity of acute postoperative pain after laparoscopic-assisted vaginal hysterectomy.

[Acupuncture combined with local anesthesia for percutaneous vertebroplasty].

OBJECTIVE: To observe the analgesic and sedative effects of acupuncture combined with local anesthesia for percutaneous vertebroplasty (PVP). METHODS: 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. RESULTS: In the observation group and control 2 group, the VAS during puncture and bone cement placement was higher than that before acupuncture (all P<0.01); the VAS during bone cement placement was higher than that before puncture (P<0.05, P<0.01); the VAS after operation was lower than that during puncture and bone cement placement (P<0.05, P<0.01). In the control 1 group, the VAS during puncture and bone cement placement and after operation was higher than that before acupuncture (P<0.01, P<0.05), the VAS after operation was lower than that during puncture and bone cement placement (P<0.05, P<0.01). There was no significant difference in VAS and Ramesy score among three groups at all time points (all P>0.05). CONCLUSION: 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.

Efficacy of parecoxib sodium on postoperative shivering: meta-analysis of clinical trials.

Objective To evaluate the effect of parecoxib on preventing postoperative shivering. Methods Main outcomes were the relative risk (odds ratio, OR) and 95% confidence interval (CI) relative to the incidence of shivering. Results Fourteen trials with 1,175 patients were analyzed. The pooled evidence suggested that parecoxib sodium, given before anesthesia or postoperatively (only 4 cases), had the potential to prevent postoperative shivering (OR = 0.21, 95% CI, 0.16, 0.29). Compared with the placebo, parecoxib sodium significantly lowered the incidence of postoperative shivering as follows: mild shivering [OR = 0.51, 95% CI (0.35, 0.74)]; moderate shivering [OR = 0.28, 95% CI (0.18, 0.45)]; severe shivering [OR = 0.18, 95% CI (0.10, 0.33)]. Compared with placebo, there was no significant association of parecoxib sodium with restlessness [OR = 0.95, 95% CI (0.59, 1.52)] or nausea/vomiting [OR = 0.24, 95% CI (0.09, 0.66)]. In addition, pethidine rescue was used significantly more often in the control group than in the parecoxib sodium group [OR = 0.22, 95% CI (0.09, 0.53)]. Conclusions Parecoxib sodium may be an effective strategy for preventing postoperative shivering.

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.

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.

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>