The Clinical Research Of Parecoxib Sodium Using As Assistant Analgesia During Epidural Anesthesia

Objective To investigate the efficacy and feasibility of parecoxib sodium using as assistant analgesia in epidural anesthesia.Methods 60 ASAⅠ～Ⅱpatients of orthopedics department aged 18～60 years without a history of gastro-duodenal ulcer or any other serious systematic diseases were scheduled for elective surgeries. Patients receiving epidural anesthesia whose pain sensation was incompletely blocked were enrolled in our study, then they were randomly divided into three groups. Group A received parecoxib 40mg (5 ml) i.v. once make sure that epidural anesthesia was not perfect, and at the beginning of bedspreading group B received fentanyl 1.5ug/kg i.v., Group C received NS 5ml. Local anesthetic was given every 60 minutes during the procedure, if the patient still felt pain, patients that VAS<4 would be given midazolam 0.03mg/kg, i.v., or would be given fentanyl 1.5-2.0 ug/kg i.v.. The time of arrival, incision,10,30,60and 90 minutes after incision and time of leave were made as testing time points. All vital signs, including RR, HR, Bp, SpO2 and so on, were monitored and recorded for each patient at all test time; Pain intensity(VAS score) at T1 and 6 hours after the procedure(T7), the total amount of extra fentanyl consumed during the procedure, and the efficiency grades of epidural anesthesia and related side effects were also recorded.Results 1.all patients in three groups had no significant difference in demographics (age, body weight and so on) and perioperative characteristics (type of surgeries, et al), (P>0.05).2.vital signs (1)intergroup comparison:The three groups had no significant difference in RR, HR, MAP and SpO2 (P>0.05). (2)intra-group comparison:①RR and HR of the three groups at T2 were significantly different from any other time point of the same group, (P<0.05);②MAP:the MAP of group A had no significantly difference between any two time points, (P>0.05), the MAP of group B at T1 were significantly higher than that of T5, (P<0.05), the MAP of group C at T1 were signicantly higher than those at T2, T4 and T6, (P<0.05);③SpO2:the SpO2 of group A, B, C had no significantly difference between any paired time points, (P>0.05); 3.VAS score:group B was significantly lower than groups A and C at T1, (P<0.05); group A was significantly lower than groups B and C at T7, (P<0.05); 4. the comsuption of fentanyl:the number of patients that needed additional fentanyl had no statistically significantly differences between three groups, (P>0.05), but the amount of fentanyl had differeces between three groups, compared with group C, group A was less (P<0.05), and group B was significantly less (P<0.01), group B was less than group A (P<0.05); 5. the efficiency grades of epidural anesthesia:group A and group B were better than group C, (P<0.05), while there was no significantly difference between group A and group B, (P>0.05); 6. side effects:group A was less than groups B and C, (P<0.05), and no significantly difference was produced between group B and group C, (P>0.05);Conclusions parecoxib sodium could be used in patients undergoing epidural anesthesia to reduce pain associated with incomplete blockage of spinal nerves, because it had available assistant analgesic effect, meanwhile it can reduce the amount of fentanyl, and reduce the incidence of adverse reactions. Meanwhile parecoxib sodium can contribute to analgesia within 6 hours after surgeries.