Analgesic Efficacy Of Intravenous Parecoxib Sodium In The Control Of Postoperative Pain In Children After Adenoidectomy And Tonsillectomy

Objective To investigate the safety and efficacy of postoperative analgesia, that give a single differnt dose of parecoxib sodium in children undergoing tonsillectomy and adenoidectomy.McGrath’s face scale, Modified Aldrete score,heart rate,parents’ and nurses’satisfaction scores,adverse rections,and mean arterial blood pressure were recorded for each patient.Simultaneous contrast the incidence of postoperative analgesia and adverse effects of ketorolac tromethamine injection group.Provide a more rational and more scientific clinical regimen and theoretical basis for guiding future pediatric postoperative analgesia.Method All the cases were from Yanbian university affiliated hospital,after obtaining approval from the local hospital ethics committee and written informed consent from parents.We studied90children,4-12years old,ASA Ⅰ-Ⅱ,undergoing tonsillectomy and adenoidectomy.Elimination standard:sever heart lung liver kidney disease,coagulation disorders,obesity,history of asthma,recent respiratory infections, airway hyperreactivity,suspected difficult airways,gastroesophageal reflux disease,NSAIDs,and sulfa drugs allergy.The patients are divided into three groups randomly,each group with30cases;All study patients were premedicated with intramuscular atropine0.01mg/kg30minutes before surgery.In the operative room:electrocardiography(ECG),noninvasive blood pressure,and pulse oximetry monitors were attached.After open vein circuit,every group intravenous fentanyl1.0ug/kg,midazolam0.08mg/kg,propofol2.5-3.0mg/kg.After tracheal intubation,the lungs were mechanically ventilated with the pressure-controlled mode(pressure-controlled ventilation at15cm H2O),and end-tidal carbon dioxide(ETCO2) tension was maintained at30-35mmHg.Intravenous fluid management included administration of lactated Ringer’s solution.Anesthesia were maintained with1.5%-2.5%sevoflurane,2L/min of oxygen flow,and intravenous remifentanil TCI infusion(TCI,target-controlled infusion).After tracheal intubation,strat intravenous parecoxib sodium and ketorolac tromethamine injection.Group Ⅰ:intravenous parecoxib0.5mg/kg;Group Ⅱ:intravenous parecoxib1.0mg/kg;Group Ⅲ:intravenous ketorolac tromethamine injection0.5mg/kg.At the end of the operation,residual neuromuscular block was reversed with neostigmine0.04mg/kg and atropine0.02mg/kg,and the endotracheal tube was removed when respiration was regular and adequate in rate and depth. Heart rate(HR),systolic(SBP) and diastolic(DBP) arterial blood pressures,oxygen saturation (SPO2), and ETCO2were monitored continuously during the procedure. After the children arrival at the PACU,Aldrete scores and postoperative observational pain scores were recorded. After lhour(T0),2hour(T1),4hour(T2),6hour(T3),8hour(T4),12hour(T5)were recorded mean arterial pressure (MAP), heart rate (HR), pulse oximetry (SpO2) values as well as children with the T0-T4time point sedation score; at the ward, observational pain scores and adverse effects were recorded during the week. Finally, recorded the parents and nurses’ satisfaction scores regarding the quality of pain managemengt.Result There were no statistical significances among three groups about children’s age, sex ratio, weight, operation time; there were no statistical significances among three groups about children’s MAP、HR、SpO2at every time point; there were no statistical significances among three groups about children’s Aldrete scores,Ramsay scores and the incidence of postoperative adverse; there were statistical significance among three groups about children’s pain scores, parents and nurses’ satisfaction scores regarding the quality of pain managemengt.Conclusion1、Intravenous parecoxib sodium injection can be applied in children’s postoperative analgesia.2、It has a very nice analgesic and can be improve the satisfaction of parents and nurse.3、It also has a good clinical safety.