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Effects of Parecoxib Pre-emptive Analgesia after Surgeries in Patients with Complicated Rentinal Detachment

Author: YeWeiZuo
Tutor: ZhouHaiYan
School: Zhejiang University
Course: Anesthesiology
Keywords: Parecoxib Analgesic Prostaglandin E2 Interleukin-6 Cortisol
CLC: R779.6
Type: Master's thesis
Year: 2010
Downloads: 7
Quote: 0
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Abstract


Objective To evaluate the preoperative use of different doses of parecoxib sodium complex retinal detachment surgery perioperative plasma prostaglandin E2 (PGE2), serum cortisol (Cor), leukocyte interleukin -6 (IL-6), postoperative analgesic, blood coagulation and renal function. Materials and methods elective complicated retinal detachment surgery 90 patients, ASA I - Ⅱ, were randomly divided into 3 groups (n = 30): parecoxib sodium 40mg (P1 group), Parry past cloth sodium 20mg (P2 group ), 0.9% sodium chloride solution 2ml (C group). 30min intravenous injection before surgery. Each patient preoperative routine local anesthesia. 30min (T1), surgery completed (T2), postoperative 2h (T3), postoperative 6h (T4) in the preoperative and postoperative 24h (T5) venous blood plasma of PGE2 measured by radioimmunoassay, serum Cor and IL- 6 concentration and determination of coagulation and renal function. The recorded postoperative T2, T3, T4, T5 visual analogue scale (VAS). Record the satisfaction of the patients in each group after 6h, 24h analgesia and 24h nausea, vomiting, pruritus, headache, bradycardia and other adverse circumstances. 1) plasma PGE2 levels: comparison with T1, T2 ~ T4 time point P2 and C groups plasma PGE2 levels increased, the difference was statistically significant (P lt; 0.05) the P1 group T2 ~ T5 time points plasma PGE2 level increased slightly, but the difference was not statistically significant (P gt; 0.05); compared with C group P2 T2 ~ T4 time point plasma PGE2 levels decreased, and the difference was statistically significant (P lt; 0.05), P1 Group T2 ~ T4 time points plasma PGE2 levels were significantly lower, and the difference was statistically significant (P lt; 0.01). 2) serum cortisol levels: compared with T1, T2 ~ T5 time point P2 and C groups plasma cortisol levels were elevated, and the difference was statistically significant (P lt; 0.05) the P1 group T3 time point plasma elevated levels of cortisol, the difference was statistically significant (P lt; 0.05); compared with C group P2 T2 ~ T4 time point in plasma cortisol levels decreased, the difference was statistically significant (P lt; 0.05), and P1 group T2 ~ T4 time point plasma cortisol levels were significantly lower, and the difference was statistically significant (P lt; 0.01). 3) serum IL-6 levels: compared with T1, T2 ~ T4 time point P2 group and group C serum IL-6 levels were increased, and the difference was statistically significant (P lt; 0.05), P1 group T2 ~ T5 time point of serum IL-6 levels increased slightly, but the difference was not statistically significance (P gt; 0.05); compared with the C group, P2 reduce the group at the point in time of T2 ~ T4 serum IL-6 levels, statistical difference significance (P lt; 0.05), P1 T2 ~ T4 time point serum IL-6 levels significantly decreased, and the difference was statistically significant (P lt; 0.01). 4) VAS score: compared with the C group, P2 Group T2 ~ T3 time-point VAS score decreased, the difference was statistically significant (P lt; 0.05); the P1 group T2 ~ T4 time point VAS score significantly reduce, the difference was statistically significance (P lt; 0.01). Compared with group P2, P1 Group T4 time point VAS scores decreased, and the difference was statistically significant (P lt; 0.05). 5) analgesic satisfaction rate: compared with the C group P2 group of patients 6h, 12 h analgesic satisfaction rate increased, the difference was statistically significant (P lt; 0.05); the P1 group patients 6h, 12 h analgesic satisfaction rate was significantly increased, the difference was statistically significance (P lt; 0.01) 6), kidney function, blood coagulation: three groups of patients with renal and coagulation functions are different, the difference was not statistically significance (P gt; 0.05 ). 7) 24-hour adverse differences among the three groups was not statistically significant (P gt; 0.05). Conclusion 1) preoperative intravenous parecoxib sodium can inhibit the inflammatory mediators of PGE2 generation of pro-inflammatory cytokines IL-6, and with the increase in the dose of parecoxib sodium inhibition also enhanced. 2) by reducing retinal detachment surgery in patients with central and outside Zhou Min role preemptive analgesia effect progressively enhanced. 3) effectively reduced by inhibiting the production of cortisol stress response, to reduce postoperative immunosuppression. 4) parecoxib sodium preemptive analgesia for patients with complex retinal detachment surgery safe, effective.

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CLC: > Medicine, health > Ophthalmology > Eye surgery and surgery
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