| Objective: To observe the effect of 40 mg of parecoxib sodium on plasma hs-CRP and serum HMGB1 as well as postoperative analgesia in patients undergoing lower limb orthopedic surgery under subarachnoid space and epidural block anesthesia.Methods: This study was approved by the Ethics Committee of the Affiliated Hospital of Yan ’an University(Approval No.:YAS-H01202111102),and 100 patients who received subarachnoid space and epidural block anesthesia for lower limb orthopedic surgery in Affiliated Hospital of Yan ’an University from May 1,2022 to November 30,2022 were selected after inclusion and exclusion criteria.Patients were divided into 2 groups with 50 cases in each group according to random number table method.All patients had the same preoperative visit,pre-anesthesia preparation,anesthesia implementation,anesthesia maintenance and intraoperative management,and postoperative management and follow-up measures.The two groups were:immediately after anesthesia,the patient was placed in supine position;control group/group A was immediately given 0.9% sodium chloride injection4.5m L intravenously;Test group/group B: immediate intravenous injection of parecoxib sodium 40mg(diluted to 4.5m L with 0.9% sodium chloride injection).Baseline data of the two groups were recorded.The plasma hs-CRP level,serum HMGB1 level and whole blood routine were measured immediately after entry(T0),immediately after operation(T1),6h after operation(T2)and 24 h after operation(T3).Pain VAS scores at 6h(T1),12h(T2),24h(T3)and 48h(T4)after surgery were observed and recorded in 2groups.Additional times of PCIA in 0～24h and 24～48h after surgery,total amount of PCIA sufentanil and total duration of use of PCIA in 2 groups were recorded.The number of zocine analgesia 48 h after surgery and the dosage of Zocine analgesia 48 h after surgery were recorded.The occurrence of intraoperative adverse reactions and postoperative complications were observed in the two groups.Results:(1)There was no statistical significance in gender,age,height,weight,BMI,and operation duration between the two groups(P > 0.05).(2)The plasma hs-CRP level of the two groups immediately after entry(T0),immediately after surgery(T1),6h after surgery(T2),24 h after surgery(T3)was significantly decreased in the experimental group at 24 h after surgery(P= 0.01).(3)There was no significant difference in serum HMGB1 II level between the two groups at any time(P > 0.05),including immediately after entry(T0),immediately after operation(T1),6h after operation(T2)and 24 h after operation(T3).(4)Whole blood routine routine results were compared between the two groups immediately after entry(T0),immediately after operation(T1),6h after operation(T2)and 24 h after operation(T3).There were no significant differences in the white blood cell count,neutrophil percentage,monocyte percentage and basophil percentage between the two groups at all times(P > 0.05).The percentage of lymphocyte in group B was higher than that in group A at 6h after surgery(P = 0.03).(5)Comparison of pain VAS scores at 6h(T1),12h(T2),24h(T3)and 48h(T4)after surgery between the two groups showed that the pain VAS at T1,T2,T3 and T4 in group B was significantly lower than that in group A(P = 0.00).(6)Comparison of supplemental times of PCIA in 0～24h and 24～48h after surgery between the two groups.Compared with supplemental times of PCIA in 0～24h after surgery,the height of group B was significantly lower than that of group A(P = 0.01);The number of additional PCIA in 24 to 48 h after surgery was significantly lower in group B than in group A(P = 0.00).(7)Compared with the total duration of postoperative PCIA,the total duration of postoperative PCIA in group B was longer than that in group A(P=0.04).(8)There was no significant difference in the total amount of PCIA sufentanil consumed between the two groups(P > 0.05).(9)The number of zocine relief analgesia 48 h after surgery in group A was significantly higher than that in group B(P = 0.00).(10)The dosage of zocine relief analgesia 48 h after surgery in group A was significantly higher than that in group B(P =0.00).(11)In this study,there was no statistical significance in the occurrence of intraoperative adverse reactions between the two groups(P > 0.05).(12)In this study,there was no statistical significance in the occurrence of postoperative complications between the two groups(P > 0.05).Conclusions: For patients undergoing lower extremity orthopedic surgery under subarachnoid space and epidural block anesthesia,a single intravenous injection of parecoxib sodium 40 mg for advanced analgesia can reduce the hs-CRP level of patients undergoing lower extremity orthopedic surgery 24 h after surgery,and can effectively relieve the early postoperative pain of patients undergoing lower extremity orthopedic surgery. |
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