Effect Of Parecoxib Sodium Combined With Dexamethasone On Recovery From Adverse Reaction To Genral Anesthesia

Objective:To investigate effect of Parecoxib Sodium combined with Dexamethasone on recovery from adverse reaction to general anesthesia.Methods:Eighty cases of patients, aged 25 to 60 years old, ASA classâ… toâ…¡, scheduled for selective modified radical mastectomy under general anesthesia, were randomly divided into four groups (n=20 each):Parecoxib Sodium group (group P), Dexamethasone group (group D), Dexamethasone combined with Parecoxib Sodium group (group C) and control group (group N). In group P, Parecoxib Sodium 40mg were administered 5minutes before induction of anesthesia and normal Saline 2ml were given in induction of anesthesia; In group D, normal Saline 2ml were administered 5 minutes before induction of anesthesia and Dexamethasone 10 mg were given in induction of anesthesia; In group C, Parecoxib Sodium 40mg were administered 5minutes before induction of anesthesia and Dexamethasone 10mg were taken in induction of anesthesia; Five minutes before induction of anesthesia and anesthesia induction, normal Saline 2ml were given in group N. Data of the 4 groups were observed and recorded. 1. anesthesia time, recovery time of consciousness and extubation time; 2. The MAP and HR before anesthesia (T1), at extubation (T2),5min after extubation (T3), 10min after extubation (T4) in four groups; 3. Reaction after extubation:(1) The status of pain and comfort (PS, RS, RSS, BCS); (2) The adverse effects after extubation (throat pain, nausea, vomiting and so on). Results:1. There was no statistical significance in the recovery time of consciousness and the extubation time among the four groups (P>0.05).2. Comparison between MAP and HR at each time point:(1) Group comparison:MAP and HR at T2,T3 in group P, group D, and group C were lower than that in group N (P<0.01), and the variance among group C, P and D was of statistical significance (P<0.01); MAP and HR at T4 in group P, D and C were lower than that in group N (P<0.01);(2) Comparison in groups:MAP and HR in all groups were the highest at T2, and declined at T3 and T4. There was statistical significance at T2 and T3 in group D (P<0.05); MAP and HR were higher at T2 than at other points in group C (P<0.05), and no statistical significance showed at T1, T3 and T4 (P>0.05). The difference at each time point was of statistical significance between group P and group N.3. Comparison of the reactions after extubation among the four groups:(1) PS and RS in group P and C were obviously lower than those in group D and N (P<0.05), but RSS and BCS were inverse (P<0.05). No statistical significance was found between group P and C (P>0.05), and group D and N as well (P>0.05). (2) The incidence of throat pain was obviously higher in group D and N than in groups P and C (P<0.05). No statistical significance existed between group D and N (P>0.05), and between group P and C (P>0.05). The incidence of nausea and vomiting were higher in group P and N than in group D and C (P<0.05). There was no statistical significance between group D and C, and between group P and N (P>0.05). There was no statistical significance in other complications (P>0.05).Conclusion:1. Both dexamethasone and Parecoxib Sodium can relieve the cardiovascular effects in extubation. 2. Parecoxib Sodium can relieve complications of agitation and pain and increase BCS after extubation, but is less effective on postoperative emesis.3. Dexamethasone can decrease the incidence of nausea and vomiting in extubation, but have less effect on postoperative analgesia. 4. Combined effect of the two is better than dexamethasone or Parecoxib Sodium alone.