The Influence On Postoperative Analgesia And Stress Response Of Parecoxib In Total Hip Replacement

Objectives:To investigate the influence on Postoperative Analgesia, IL-6,TNF-aand Cor of Parecoxib in total hip replacement and provide a reference for Clinical analgesic regimenMethods:60 patients grading ASAI-III and undergoing selective THR operation were randomly divided into 3 groups, group A, B and C,20 cases in each one. They were treated as follows, respectively:1,the patients in Group A were intravenous injected with 2ml saline before skin cut and when skin closure2,the patients in Group B were intravenous injected with 2ml saline before skin cut, intravenous injected with 40mg parecoxib when skin closure3,the patients in Group C were intravenous injected with 40mg parecoxib, ntravenous injected with 2ml saline when skin closureThere are no significant difference among the three groups on the age,weight,surgical time,bleeding。Three groups took fentanyl PCIA after operation.Venous blood sample were taken at the time before anesthesia(T1), at the end of the operation(T2),6 hours after operation(T3),12 hours after operation(T4),24 hours after operation(T5) measured the levels of plasma Interleukin-6,TNF-aand Cor;Recorded the visual analogue score (VAS) at2,4,6,12,24,48hours after operation, recorded the consumption of total fentanyl in the 24 hours.besides the side effects were recored24 hours after operation such as dizziness, nausea, vomiting, respiratory inhibition, arrhythmia.Results:There are no obvious difference among the three groups of patients on age, weight, gender, operation time,bleeding (P>0.05).1,Postoperative each date when silience, treatment groups with in 24h VAS score significantly lower than A group (P<0.05), group C is slightly lower than B, but this was not statistically significant (P>0.05). VAS score 48h had no statistical significance difference mong three groups (P>0.05). when activities, group C was lower than group B in 12h.treatment groups of postoperative consumpped fentanyl less than in control group (P<0.05), the difference, group C consumpped less than group B (P>0.05)2,1)At T1, T2 and T3, TNF- a level of the three groups kept stable,there were no significant difference (P>0.05), At T4, T5,the level was higher than before operation (P<0.05), compared with A group, B and C group at T4, T5,TNF -a level was lower (P<0.05), between group B and C group, there were no obvious difference (P> 0.05).2) At T3, T4and T5, IL₆ level of the three groups began to rise than TI, compared with A group, B and C group at T3,T4, T5, plasma IL-6 was lower significantly,the difference was the statistically significant(P<0.05). between group B and C group, there were no obvious difference (P>0.05).3)Cor level of the three groups began to rise than before operation,between group B and C group, there were no obvious difference (P>0.05). compared with A group, B and C group after operation, plasma Cor was lower significantly,the difference was the statistically significant(P<0.05)Conclusions:1,Parecoxib with the fentanyl PCIA could release the pain after total hip replacement, reduce drug usage and side effects of opiates occur.2,Parecoxib could reduce perioperative cause stress response to the body to a certain extent, either premedieation or postmedication.