Effect Of Perioperative Parecoxib Sodium Combined With Dexmedetomidine On Gastrointestinal Function After Laparoscopic Gastric Cancer Surgery In Elderly Patients

Objective There are many postoperative complications of laparoscopic gastric cancer surgery in elderly patients.The most common is postoperative gastrointestinal dysfunction,which will directly affect the rapid recovery of patients after surgery,increasing family support and economic burden.The most likely cause of postoperative gastrointestinal dysfunction is the stress response caused by surgical trauma.The perioperative stress response can not only affect the rapid recovery of patients' organs,but also increase postoperative complications.However,the elderly patients with laparoscopic gastric cancer have reduced body function,and their tolerance to anaesthesia and surgery is worse.This requires our anesthesiologists to consider in order to achieve stable and safe perioperative period for elderly patients.The application of parecoxib sodium and dexmedetomidine respectively can effectively reduce the inflammatory response,reduce the release of inflammatory factors,protect the body organs,reduce postoperative complications,thereby shortening the length of hospital stay and the cost,and promoting patients Quick recovery.This project intends to study the effect of parecoxib sodium combined with dexmedetomidine on the gastrointestinal function after laparoscopic gastric cancer surgery in elderly patients under the monitoring of inflammatory factors.Method Ninety patients who planned to undergo laparoscopic gastric cancer surgery from January 2018 to August 2019 at Chaohu Hospital affiliated to Anhui Medical University were randomly selected.Male / female: 46/44,aged 65-85;ASA classification grades ? to ?.;cardiac function grades ? to ?.Exclusion criteria: patients with gastrointestinal motility disorders;history of abdominal surgery;patients with severe liver and kidney dysfunction;heart rate <45 beats / min;patients with ? to ? degree atrioventricular block;severe arrhythmia;taking antipsychotic drugs;A history of dementia and mental illness.Random number table method was used to randomly divide into Parecoxib sodium(P)group,Dexmedetomidine(D)group and Parecoxib sodium combined with dexmedetomidine group(PD)group,There were 30 cases in each group.Group P and PD groups were given parecoxib sodium 40 mg intravenously 15 minutes before induction of anesthesia.Group D and PD groups were given dexmedetomidine 1 ug / kg 15 minutes before induction of anesthesia.0.3 ?g·kg-1·min-1 The pump was maintained,and the infusion stopped at the end of the operation.Blood was drawn at the time of awake(T0),1 h(T1)after the start of the operation,and 15min(T2)after the end of the operation,and the monitoring levels of IL 2,IL 6,and TNF-a were recorded.The patients 'pain scores were evaluated at 2h,12 h,and 24 h after the operation.The patients were followed up by a special person within 10 days after the operation.The patients' gastrointestinal function recovery,hospitalization costs,and postoperative complications were followed up.Results Compared with T0 when awake,IL 6 and TNF-a at T1 and T2 in all patients in the P,D,and PD groups were significantly increased,and IL 2 was significantly decreased.The difference was statistically significant(P <0.05);Compared with group D and group D,PD 6,IL 6 and TNF-a significantly decreased and IL 2 increased significantly at T1 and T2 in PD group(P <0.05).Compared with group P and D,PD group The recovery time of gastrointestinal tract was significantly shorter,and the cost of hospitalization was significantly reduced,the difference was statistically significant(P <0.05);the incidence of postoperative complications was lower in the PD group than in the P and D groups,and the difference was statistically significant(P <0.05).Conclusion The most important mechanism of changes in the levels of IL 6,TNF?,and IL 2 during perioperative period in elderly patients undergoing laparoscopic gastric cancer surgery is the perioperative stress response.Perioperative combination of parecoxib sodium and dexmedetomidine can reduce the occurrence of stress reactions,promote rapid recovery of gastrointestinal function,reduce postoperative complications,and maintain the Functional stability plays a positive role.