Effect of intravenous injection of parecoxib before operation on efficacy of postoperative analgesia in patients undergoing thoracic surgery
10.3760/cma.j.issn.0254-1416.2010.12.010
- VernacularTitle:术前静脉注射帕瑞昔布钠对胸外科手术病人术后镇痛效果的影响
- Author:
Jianluo SI
;
Yue SU
;
Shaotuan SONG
- Publication Type:Journal Article
- Keywords:
Cyclooxygenase inhibitors;
Analgesia;
Thoracic surgical procedures
- From:
Chinese Journal of Anesthesiology
2010;30(12):1440-1442
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of intravenous injection of parecoxib before operation on the efficacy of postoperative analgesia in patients undergoiag thoracic surgery.Methods Ninety ASA Ⅰ -Ⅲ patients,aged 38-76 yr,weighing 44-82 kg,scheduled for thoracic surgery under general anesthesia combined with thoracic epidural block,were randomly divided into 3 groups(n = 30 each): group A,B and C.Epidttral anesthesia was performed at the T6-7 interspace before general anesthesia. Anesthesia was induced with sufentanyl 0.4 μg/kg,vecuronium 0.12 mg/kg and propofol 1.5-2.0 mg/kg.Double-lumen bronchial tube was inserted and the patients were mechanically ventilated.Group A received iv injection of normal saline 2 ml 30 min before skin incision.Group B received iv parecoxib sodium 40 mg after extubation.Group C received iv parecoxib sodium 40 mg 30 min before skin incision.Anesthesia was maintained with propofol,vecuronium,sufentanyl and lidocaine.The patients received patient-controlled epidural analgesia(PCEA)with ropivacaine and 0.5 μg/ml sufentanil after surgery.The VAS score was maintained≤ 3.The comfort level was evaluated with Bruggrmann comfort scale(BCS)at 4,12,24 and 48 h after operation.The consumption of sufentanil during operation and within 48 h after operation was recorded.The adverse reactions were also recorded.Results Compared with group A,the consumption of sufentanil was significantly decreased in group B and C,the BCS score was significantly increased at 4 h after operation in group B,and the BCS score was significantly increased at each time point and the consumption of sufentanil during operation was significantly decreased in group C(P < 0.05).The BCS score was significantly higher,and the consumption of sufentanil during operation and within 48 h after operation was significantly lower in group C than in group B(P < 0.05).There was no significance difference in the adverse reactions among the 3 groups(P > 0.05).Conclusion Intravenous injection of parecoxib 40 mg before operation reduces the perioperative sufentanil consumption in patients undergoing thoracic surgery.