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In today's modern medical technology with each passing day, the postoperative analgesia has been considerable and steady development. For patients after renal transplantation, the pain increased sympathetic activity can cause stress response, malignant hypertension, oliguria, or even delayed graft function recovery and other adverse complications; patients can also lead to psychological suffer from insomnia, anxiety, irritability and even helpless feeling; physiological stimulation resulted in vivo catecholamine hormones such levels, oliguria, hypertension and other phenomena, which occurred in the delayed graft function recovery (delayed graft function, DGF) and other serious consequences. Preoperative patients with end-stage renal failure and hypertension symptoms are caused by non-capacity factors, the body of catecholamines, antidiuretic hormone, renin - angiotensin level of the original has been elevated, and surgical trauma, blood loss and postoperative pain can be causes the body to produce a stress reaction, the vasoconstrictor substance secretion further increase may lead to renal vasoconstriction, renal perfusion decreased blood flow, is not conducive to moving, the opening up of the venous flow transplanted kidney perfusion. Anesthesia and postoperative analgesia is not only the need for surgery, also a transplant kidney recovery needs. In addition to ensuring the good intraoperative anesthesia management, kidney transplant patients should also take effective analgesic means. Parecoxib sodium is a new kind of specificity the epoxide hydrolase -2 (Cyclooxygenase-2 and COX-2) inhibitors, drugs in the body quickly and almost completely transformed into valdecoxib and propionic acid, cutting ground celecoxib elimination in the liver extensively through a variety of channels, less than 5% of the valdecoxib through urine excretion in prototype form. Varying degrees of renal damage in patients with intravenous Parry celecoxib sodium 20mg parecoxib sodium rapid clearance from the plasma. Major route of elimination of the kidneys to eliminate not valdecoxib and celecoxib, valdecoxib clearance rate of change was not found even in severe renal impairment or rely on dialysis patients. By our hospital ethics committee approved the study, randomly selected from January 2009 to March 2011, 48 kidney transplantation patients, aged 18-60 years, BMI (body mass index, BMI) ≤ 28.0kg / m2, the American Society of Anesthesiologists classification (the American Society ofAnesthesiologists, ASA) of Ⅲ ~~ Ⅳ preoperative fasting water 6-8 hours, to exclude secondary kidney transplant patients, patients with liver dysfunction, gastrointestinal ulcers in patients with a history and known drug allergy in patients with non-steroidal anti-inflammatory drugs (Non-Steroid Anti-Inflammatory Drugs, NAIDs). Open peripheral vein in the patient after the burglary, routine monitoring of electrocardiogram (ECG), pulse oximetry (SPO2), local anesthesia monitoring of radial artery puncture invasive blood pressure (IBP) and the right internal jugular vein puncture of rapid infusion channel and monitoring center venous pressure (CVP), all patients using intravenous anesthesia, etomidate 0.3mg/kg cis atracurium 0.2mg/kg intravenous midazolam 0.04mg/kg, fentanyl 4ug/kg, tracheal intubation, and intraoperative propofol, remifentanil and cis-atracurium continuous infusion to maintain anesthesia. The patients were randomly divided into three groups, were recorded as fentanyl group (F), parecoxib sodium group (P group) and control group (N group). Three groups of 10 mmin anesthetic before discontinuation by intravenous Parecoxib 40mmg, and fentanyl 0.1mg and normal saline 2 ml of. Observed before extubation 5min (T1), extubation instantly (T2), 5min (T3) after extubation extubation after 10min (T4) blood pressure, pulse oximetry (SPO2), heart rate (HR) and central venous The change in pressure (CVP), and at the same time recording whether patients cough, nausea, vomiting, sedation evaluation of patients, the initial evaluation of patients with visual analogue scale (Visual Analogue Scale / Score, VAS). Observed after extubation 15min evacuation Transplant Unit intensive care ward. Postoperative 36h venous serum creatinine (Cr) were taken in the preoperative and postoperative 12h, blood urea nitrogen (BUN), recorded after 12 hours, 36 hours urine output.
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