The Administration Of Selective COX-2Inhibitor In The Treatment Of Perioperative Pain After Orthopadeic Surgery

ObjectiveTo investigate the clinical outcome and machanism of celecoxib and parecoxib sodium inOrthopadeic perioperation analgesia.Method44and48patients respectively scheduled for spinal surgery and Total Hip Arthoplasty wererandomly divided into two groups.Experimental and control group had46patientsrespectively.The COX-2inhibitor was used in Experimental group.400mg of celecoxib at2hpreooperation and40mg of parecoxib sodium instantly after operation,per12hours,were used.The patient-controlled intravenous analgesia(PCIA) was used in46patients of Control group afteroperation. To measure the level of COX-2（cyclooxygenase-2）and PGE2（prostaglandin E2）inthe day before surgery,instant and48h after surgery.To evaluate the postoperative pain ofexperimental and control group in8h,24h,48h and72h after operation by the visual stimulationanalysis(VAS).To compare the blood loss during operation,the volumn of drainage in48h afteroperation and the incidence of drug adverse reaction in experimental and control group.ResultThe score of VAS,the level of PGE2and COX-2, instant and48h after operation inexperimental group was less than control group. The blood loss during operation,the volumn ofdrainage in48h after operation and the incidence of drug adverse reaction in experimental andcontrol group had no difference.Conclusion1.To kill pain in orthopaedic perioperation of spine and THA surgery,Adminstration of, theCOX-2inhibitor,400mg celecoxib2h preoperation and40mg of parecoxib sodium instantly afteroperation,per12hours and6times totally, were safe and reliable.The clinical outcome of COX-2inhibitor was better than anaesthetic medicine.It can satisfied the need of Orthopadeicperioperation analgesia.Additionally,we can use multimodal analgesia if necessary. 2.During Orthopadeic perioperation,the COX-2inhibitor decreased the release of mediators ofinflammation and enzyme correlated with pain significantly. Especially to restrain the release ofPGE2, the irritation of pain after operation were weakened obviously.