Effect of celecoxib on early postoperative cognitive function in elderly patients with hip fracture
10.3760/cma.j.cn115455-20191114-00917
- VernacularTitle:塞来昔布对老年髋部骨折患者术后早期认知功能的影响
- Author:
Bo LI
1
;
Jingna XU
Author Information
1. 上海市松江区方塔中医医院麻醉科 201600
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(9):835-839
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effects of celecoxib on postoperative cognitive function in elderly patients with hip fracture.Methods:One hundred and thirty patients with hip fracture patients from July 2017 to July 2019 in Shanghai Songjiang Fangta Hospital of Traditional Chinese Medicine were selected. All patients were treated with the same anesthetic and surgical methods. The patients were divided into celecoxib group (66 patients) and control group (64 patients) by random number table method. The patients in celecoxib group were given oral administration of celecoxib 200 mg 12 h before surgery and 12, 24, 48 h after surgery; the patients in control group were given oral administration of placebo at the same time. Patients were treated with sufentanil intravenous analgesia pump. The serum levels of C reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and prostaglandin E 2 (PG-E 2) 12 h before surgery and 4, 24, 48 h after surgery were determined. The pain intensity 1, 4, 24 and 48 h after surgery was measured by visual analogue scale (VAS) score. Cognitive function before surgery and 7 d after surgery was assessed by mini-mental state examination (MMSE), and the MMSE 7 d after surgery <23 scores was diagnosed postoperative cognitive dysfunction (POCD). Results:There was no statistical difference in VAS score 1 and 4 h after surgery between 2 groups ( P>0.05); the VAS score 24 and 48 h in celecoxib group was significantly lower than that in control group: (4.3 ± 1.2) scores vs. (6.1 ± 1.6) scores and (4.0 ± 0.9) scores vs. (7.8 ± 1.3) scores, and there was statistical difference ( P<0.05). There were no statistical difference in CRP, IL-6, TNF-α and PG-E 2 12 h before surgery between 2 groups ( P>0.05); the CRP, IL-6, TNF-α and PG-E 2 4, 24 and 48 h after surgery in celecoxib group were significantly lower than those in control group, and there were statistical differences ( P<0.05). There was on statistical difference in MMSE before surgery between 2 groups ( P>0.05); MMSE 7 d after surgery in celecoxib group was significantly higher than that in control group: (25.1 ± 1.9) scores vs. (23.9 ± 1.5) scores, the incidence of POCD was significantly lower than that in control group: 10.6% (7/66) vs. 28.1% (18/64), and there were statistical differences ( P<0.05). Conclusions:Celecoxib can decrease early POCD incidence after hip fracture surgery in elderly patients, which might be mediated by suppressing inflammation and acute postoperative pain caused by surgical trauma.
