Eeffect of parecoxib on inflammatory response after radical lung cancer surgery in elderly patients
10.3760/cma.j.issn.0254-1416.2012.12.002
- VernacularTitle:帕瑞昔布钠对肺癌根治术老年病人术后炎性反应的影响
- Author:
Fuguo MA
;
Bin WANG
;
Mingshan WANG
;
Lixin SUN
;
Qiang WANG
;
Fei SHI
- Publication Type:Journal Article
- Keywords:
Cyclooxygenase 2 inhibitors;
Inflammation;
Postoperative complications;
Aged
- From:
Chinese Journal of Anesthesiology
2012;(12):1421-1424
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of parecoxib on the inflammatory response after radical lung cancer surgery in elderly patients.Methods Forty-one ASA Ⅱ or Ⅲ elderly patients of both sexes,aged 65-78yr,weighing 52-81 kg,undergoing elective radical lung cancer surgery performed via a thoracoscope,were randomly divided into control group (group C,n =20) and parecoxib group (group P,n =21).Tracheal intubation was performed after induction of anesthesia.Anesthesia was maintained with intravenous infusion of remifentanil and propofol,inhalation of sevoflurane and intermittent intravenous boluses of vecuronium.Bispectral index value was maintained at 40-50.Group P received intramuscular parecoxib sodium 40 mg at 30 min before anesthesia and at 12,24 and 36 h after surgery.The equal volume of normal saline was given in group C.Both groups received patient-controlled intravenous analgesia with morphine after operation.VAS scores at rest were maintained ≤ 3.The consumption of morphine and Ramsay sedation score at 12,24 and 48 h after operation were recorded.Blood samples were taken from the central vein before surgery (T0),at the end of surgery (T1) and at 12,24 and 48 h after surgery (T2-4) for determination of plasma TNF-α and IL-8 concentrations.Blood samples were collected from the radial artery at T0-4 for determination of PaO2.Alveolar-arterial oxygen tension difference and oxygenation index were calculated.Pulmonary complications were recorded within 2 days after surgery.Results The consumption of morphine,Ramsay sedation score,plasma TNF-α and IL-8 concentrations,alveolar-arterial oxygen tension difference and incidence of pulmonary complications were significantly lower,and oxygenation index was significantly higher in group P than in group C (P ＜ 0.05).Conclusion Parecoxib can reduce the inflammatory response after radical lung cancer surgery in elderly patients,thus improving respiratory function and reducing pulmonary complications after surgery.
