Early Application Study of Intravenous Pain Pump Combined with Parecoxib Injection in Relieving Pain in Patients after Thoracoscopy

Objective: To explore the clinical effectiveness of combined use of intravenous pain pump with Parecoxib injection in alleviating pain in patients during the early postoperative period after thoracoscopic surgery. Methods: Eighty patients who underwent thoracoscopic surgery in a tertiary hospital were selected as the study subjects and randomly divided into two groups, with 40 patients in each group. The control group received routine postoperative treatment with intravenous pain pump, while the experimental group received Parecoxib in addition to the standard postoperative pain pump treatment. Visual Analog Scale (VAS) pain scores were used to evaluate postoperative pain relief in both groups, along with adverse reactions, postoperative complications, and patient satisfaction with pain relief. Results: Patients who received Parecoxib injection in addition to the routine use of intravenous pain pump had VAS pain scores lower than 3 points at 6 h, 12 h, 24 h, and 36 h postoperatively compared to those in the control group. The incidence of postoperative lung collapse, pleural effusion, and pulmonary infections was also significantly lower in the experimental group. The differences between the two groups were statistically significant (P Conclusion: Early combined use of Parecoxib injection in the early postoperative period after thoracoscopic surgery has shown good clinical efficacy. It can reduce the level of pain in patients, promote effective coughing and expectoration, facilitate early mobilization of patients, improve patient compliance, reduce complications, shorten hospital stay, and expedite patient recovery. Therefore, it is worth promoting the widespread clinical application of Parecoxib injection in this setting.

Efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy:A prospective,randomized study

AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.

Comparison of intra-articular injection of parecoxib vs oral administration of celecoxib for the clinical efficacy in the treatment of early knee osteoarthritis

BACKGROUND Non-steroid anti-inflammatory drugs(NSAIDs)have played a crucial role in the treatment of osteoarthritis,especially in the early stages.However,the cardiovascular risk and adverse gastrointestinal reactions of oral NSAIDs in elderly people cannot be underestimated.Intra-articular injection of NSAIDs may be a new attempt for early knee osteoarthritis treatment.Parecoxib may be a suitable drug for intra-articular injection.AIM To observe the clinical efficacy of the intra-articular injection of parecoxib for early knee osteoarthritis.METHODS Early knee osteoarthritis patients(n=110)were retrospectively analyzed.These patients were divided into three groups:Basic treatment+oral glucosamine(group A,n=37),oral celecoxib+basic treatment+oral glucosamine(group B,n=37),and intra-articular injection of parecoxib+basic treatment+oral glucosamine(group C,n=36).Intra-articular injection of parecoxib was performed once every 2 wk at a dose of 40 mg each time,for three times total.The three groups were compared in terms of visual analogue scale(VAS)scores,Hospital for Special Surgery(HSS)scores and patient satisfaction before and after treatment.The levels of inflammatory cytokines in the synovial fluid were detected in the three groups before and after treatment.RESULTS All patients were followed up for an average of 15.5±2.7 mo.The clinical efficacy was estimated by VAS and HSS scores at 12 mo after treatment.Inflammatory cytokine levels in the synovial fluid were evaluated at 3 mo after treatment.VAS and HSS scores were significantly improved in each group compared with before(P<0.001).There were significant differences among the three groups in VAS and HSS scores(P<0.001).The clinical efficacy of group C was superior to that of groups A and B(P<0.001),while group B outperformed group A in this respect(P<0.001).The patient satisfaction was the highest in group C(P<0.001).After treatment,the levels of tumor necrosis factorα(TNF-α)and interleukin(IL)-6 in the synovial fluid decreased in each group compared with before(P<0.001),while the levels of IL-10 increased(P<0.001).The three groups differed significantly in the levels of TNF-a,IL-6 and IL-10 in the synovial fluid after treatment(P<0.001).CONCLUSION For patients with early knee osteoarthritis,intra-articular injection of parecoxib could effectively improve clinical symptoms.This method may be a reliable alternative for early knee osteoarthritis.

Analgesic effect of parecoxib combined with ropivacaine in patients undergoing laparoscopic hepatectomy

BACKGROUND Currently, there is no uniform standard for analgesia during laparoscopic hepatectomy. Most of the analgesia schemes adopt epidural analgesia after laparotomy. Although the analgesia is effective, it has a great impact on the recovery of patients after laparoscopic hepatectomy and is not completely suitable for analgesia after laparoscopic hepatectomy. Although multimodal perioperative analgesia can significantly relieve postoperative pain, there is no relevant study of parecoxib combined with ropivacaine for post-laparoscopic hepatectomy analgesia. AIM To study the analgesic effect of the preoperative intravenous injection of parecoxib combined with long-acting local anesthetic ropivacaine for incision infiltration in patients undergoing laparoscopic hepatectomy. METHODS Forty-eight patients undergoing laparoscopic hepatectomy were randomly divided into a combined group (parecoxib combined with ropivacaine) and a control group. The visual analogue scale (VAS) at rest and during movement was used to compare the analgesic effect of the two groups. Meanwhile, the cumulative sufentanil, the recovery time for enterokinesia, the length of postoperative hospital stay, and the adverse reactions (nausea and vomiting) were recorded and compared between the two groups.The change tendency in VAS scores for both groups was similar after operation. At rest, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, 24 and 36 h, and during movement, the VAS scores of the combined group were significantly lower than those of the control group at 0, 6, 12, and 24 h. The recovery time for enterokinesia in the combined group was 2.9 d, which was significantly shorter than that in the control group. The cumulative sufentanil in the combined group decreased significantly at 24, 36, and 48 h after operation. CONCLUSION Preoperative intravenous injection of parecoxib combined with ropivacaine for incision infiltration is a simple and effective method for postoperative analgesia in laparoscopic hepatectomy, which could relieve pain and promote recovery.

Efficacy and Safety of COX-2 Inhibitor Parecoxib for Rigid Cystoscopyrelated Pain Management in Male Patients:A Prospective,Randomized and Controlled Study

Using anesthetic gel may not sufficiently exclude pain perception during and after cystoscopy in male patients.To evaluate the analgesic efficacy and safety of intramuscular parecoxib(40 mg)for outpatient-based rigid cystoscopy,we performed a prospective,randomized and controlled study.Consecutive male patients requiring diagnostic cystoscopy in our hospital were divided into group A(1%tetracaine gel,n=50)and group B(parecoxib,n^5l)at random.Patients received intramuscular injections of either 2 mL sterile saline in group A or 40 mg parecoxib in group B 30 min before the procedure.Tetracaine gel was injected into the urethra 3 min before the procedure in group A,with patients receiving plain lubricant gel in group B at the same time.Cystoscopy-associated pain levels were evaluated using the Visual Analog Score(VAS)during the procedure.Post-procedure urethral pain and complications were recorded and analyzed.The results showed that male patients experienced significantly less pain in group B than in group A(2.70±1.36 V5.3.56±1.74,P=0.008).The percentage of patients with dysuria pain was not significantly different between the two groups.In addition,24 h after cystoscopy,the patients with no previous experience of cystoscopy were more likely to declare urethral pain(59.2%vs.33.3%,P=0.012,relative risk=1.78).No difference was observed in analgesic-related complications between the two groups.We conclude that intramuscular injection of 40 mg parecoxib may improve comfort for male patients undergoing rigid cystoscopy.

Influence of the dexmedetomidine combined with parecoxib sodium on inflammatory factor, blood gas analysis and stress hormone levels in patients undergoing radical resection of esophageal carcinoma during one lung ventilation

Objective: To investigate the effect of dexmedetomidine combined with parecoxib sodium on the levels of inflammatory factors, blood gas analysis and stress hormone in patients undergoing radical resection of esophageal carcinoma during one lung ventilation. Methods:According to the random data table, 81 cases of esophageal cancer patients were divided into the control group (n=41) and observation group (n=40), the patients in the two groups underwent left thoracotomy esophageal cancer radical resection, the control group patients were treated with parecoxib sodium, and patients in the observation group were treated with parecoxib sodium combined with dexmedetomidine medetomidine treatment, before induction of anesthesia (T0), 30 min of one lung ventilation (T1) and 120 min after operation (T2) at three time points, the levels of inflammatory factors [tumor necrosis factor-α (TNF-α), C reactive protein (CRP)], blood gas analysis[oxygen partial pressure (PaO2), carbon dioxide partial pressure (PaCO2)] and stress hormone[epinephrine (E), norepinephrine (NE)] of the two groups were compared. Results: Intra group level comparison, compared with the levels of two groups at the T0 moment, the levels of TNF-α, CRPand NE of theT1 and T2 moment were significantly increased, the level of PaO2 were significantly decreased, and T2 moment levels were significantly higher than that of T1 moment, the difference was statistical significance;There were no significant differences between the two groups of the levels of TNF-α, CRP, PaO2, E and NE of the T0 moment, the levels of TNF-α, CRP, E and NE of the observation group at the T1 and T2 moment were significantly lower than the control group, at the same time the PaO2 level was significantly higher than the control group, the difference was statistically significant;There were no statistically significant differences in PaCO2 levels between groups and at any time. Conclusion: Dexmedetomidine combined with parecoxib sodium can effectively relieve the inflammatory stress, improve the levels of the blood gas analysis index and stress hormone during one lung ventilation, has an important clinical value.

Study on the value of parecoxib sodium preemptive analgesia for laparoscopic surgery based on postoperative pain and stress mediator secretion

Objective:To investigate the effect of parecoxib sodium preemptive analgesia on postoperative pain and stress response in patients with laparoscopic surgery.Methods:118 patients with asymptomatic gallbladder polyps who underwent elective laparoscopic surgery in our hospital between January 2018 and January 2019 were divided into the control group(n=59)and the preemptive analgesia group(n=59)by random number table.Control group received routine total intravenous anesthesia,and preemptive analgesia group received intravenous injection of parecoxib sodium 0.7mg/kg during anesthesia induction.The differences in serum levels of pain mediators[prostaglandin E2(PGE2),substance P(SP)and neuropeptide Y(NPY)],inflammatory factors[interleukin-1β(IL-1β),interleukin-6(IL-6)and interleukin-12(IL-12)]as well as stress mediators[cortisol(Cor),norepinephrine(NE)and epinephrine(E)]at before surgery(T0),30min after extubation(T1),6h after surgery(T2)and 24h after surgery(T3)were compared between the two groups of patients.Results:At T0,there was no significant difference in VAS score as well as inflammatory factor or stress mediator levels between the two groups(P>0.05).At T1,T2 and T3,VAS scores of the preemptive analgesia group were lower than those of the control group;serum IL-1β,IL-6,IL-12 and TNF-αlevels were lower than those of the control group;serum Cor,NE and E levels were lower than those of the control group(P<0.05).Conclusion:Parecoxib sodium preemptive analgesia has a positive effect on reducing postoperative pain and systemic stress in patients with laparoscopic cholecystectomy.

Effects of parecoxib + dexmedetomidine on systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery

Objective: To study the effects of parecoxib + dexmedetomidine on systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery. Methods:The lung cancer patients undergoing thoracoscopic surgery in Kailuan General Hospital between March 2015 and February 2018 were selected as the research subjects and randomly divided into the experimental group who received parecoxib + dexmedetomidine preemptive analgesia combined with conventional anesthesia and the control group who received conventional anesthesia. 3 and 5 d after surgery, serum was collected to measure the contents of inflammatory cytokines interferon-γ (IFN-γ), interleukin-1β (IL-1β), interleukin-18 (IL-18), intercellular adhesion molecule-1 (ICAM1) and monocyte chemoattractant protein-1 (MCP1) as well as oxidative stress mediators cortisol (COR), malondialdehyde (MDA), endothelin-1 (ET-1), superoxide dismutase (SOD) and total antioxidant capacity (T-AOC), and peripheral anticoagulant blood was collected to measure the expressions of inflammatory signaling molecules Toll-like receptor 4 (TLR4), NOD-like receptor protein 3 (NLRP3), nuclear factor-κB (NF-κB), apoptosis-associated speck-like protein containing CARD (ASC) and cysteinyl aspartate specific proteinase-1 (caspase-1) as well as oxidative stress molecules nuclear factor E2-related factor 2 (NRF2), antioxidant response element (ARE), NADPH oxidase (NOX) 2 and NOX4. Results: 3 and 5 d after surgery, serum IFN-γ, IL-1β, IL-18, ICAM1, MCP1, COR, MDA and ET-1 contents as well as peripheral blood TLR4, NLRP3, NF-κB, ASC, Caspase-1, NRF2, ARE, NOX2 and NOX4 expression intensity of the experimental group were significantly lower than those of the control group whereas serum SOD and T-AOC contents were higher than those of the control group. Conclusion: Parecoxib+ dexmedetomidine can inhibit the systemic inflammation and oxidative stress during anesthesia recovery period of thoracoscopic surgery.

Effect of parecoxib sodium intervention before induction on incision pain and inflammatory stress response after orthopedic surgery

Objective:To study the effect of parecoxib sodium intervention before induction on incision pain and inflammatory stress response after orthopedic surgery.Methods: Patients who underwent orthopedic surgery under lumbar anesthesia combined with epidural block anesthesia in Mianyang Central Hospital between March 2015 and June 2017 were selected and divided into two groups by random number table method, Par group received parecoxib sodium intervention before induction combined with routine postoperative patient-controlled intravenous analgesia, and control group only accepted routine postoperative patient-controlled intravenous analgesia. The pain neurotransmitters, inflammatory molecules and stress molecules in serum and peripheral blood were measured before surgery as well as 1 day and 3 days after surgery.Results: Compared with pain neurotransmitters of same group before surgery, serum PGE2, 5-HT, SP, NPY levels of both groups were significantly lower whereas serum COR and GH levels and peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression were significantly higher 1 day and 3 days after surgery, and serum PGE2, 5-HT, SP, NPY, COR and GH levels as well as peripheral blood JAK2, STAT3, IL-1, IL-6, IFIT1, Nrf2 and HO-1 mRNA expression of Par group 1 day and 3 days after surgery were lower than those of control group.Conclusions: Parecoxib sodium intervention before induction can reduce the incision pain and inflammatory stress response after orthopedic surgery.

Analgesic effect of oxycodone combined with parecoxib sodium after laparoscopic cholecystectomy and its influence on inflammatory stress response

Objective: To discuss the analgesic effect of oxycodone combined with parecoxib sodium after laparoscopic cholecystectomy and its influence on inflammatory stress response. Methods:A total of 260 patients with chronic cholecystitis who accepted laparoscopic cholecystectomy in this hospital between December 2016 and May 2017 were divided into control group (n=130) and oxycodone group (n=130) by random number table method. Control group received morphine combined with parecoxib sodium analgesia after operation, and oxycodone group received oxycodone combined with parecoxib sodium analgesia after operation. The differences in serum levels of pain mediators, inflammatory mediators and stress hormones were compared between the two groups immediately after operation (T0), 12 h after operation (T1) and 24 h after operation (T3). Results: At T0, there was no statistically significant difference in serum levels of pain mediators, inflammatory mediators and stress hormones between the two groups. At T1 and T2, serum pain mediators PGE2, NPY, SP and NGF levels of oxycodone group were lower than those of control group whereas β-EP levels were higher than those of control group;serum inflammatory mediators CRP, IL-1β, IL-6 and TNF-αlevels were lower than those of control group;serum stress hormones Cor, NE and INS levels were lower than those of control group. Conclusion: Oxycodone combined with parecoxib sodium analgesia after laparoscopic cholecystectomy can effectively relieve the pain perception and inhibit the systemic inflammatory response and stress response.

Clinical analysis of the effect of preemptive analgesia with parecoxib sodium on the corresponding index in cesarean section

Objective:To explore the application of parecoxib preemptive analgesia effect on maternal inflammatory factor, substance P and the stress index in cesarean section.Methods:A total of 84 cases of cesarean section in our hospital from April 2015 to February 2017 were selected and randomly divided into the observation group and the control group with 42 cases each. The observation group received parecoxib sodium before anesthesia induction to 30 min, and control group was given normal saline, respectively. The venous blood samples were collected at the end of the operation, 30 min, 4 h, 8 h and 12 h after operation respectively. The inflammatory factors, P substances and stress indexes were compared between the two groups before and after operation.Results:Substance P in the two groups increased at the end of 30 min after operation, and reached a high peak at 4 h after operation, and then decreased gradually. E (epinephrine) and NE (norepinephrine) reached peak values at 30 min after surgery and then decreased gradually. After the operation, the 30 min, 4 h, postoperative 8 h and postoperative 12 h, P, E and NE indexes in the observation group were lower than those in the control group at the same time point, and the difference was statistically significant. Conclusion: The clinical effect of parecoxib sodium preemptive analgesia in cesarean section is better. It can effectively reduce inflammatory reaction, relieve pain, relieve stress reaction and promote postoperative recovery. It is recommended to be widely used in clinic.

Effects of parecoxib sodium intervention before induction on inflammatory stress response and endocrine steady state after laparoscopic surgery

Objective:To study the effects of parecoxib sodium intervention before induction on the inflammatory stress response and endocrine steady state after laparoscopic surgery.Methods:120 cases of patients who accepted laparoscopic cholecystectomy in the Second Affiliated Hospital of Xi'an Medical University between March 2015 and December 2016 were selected and randomly divided into the parecoxib group who accepted parecoxib sodium combined with general anesthesia and the control group who accepted general anesthesia. Before anesthesia induction (T0), immediately after extubation of anesthesia (T1) and 6 hours after extubation (T2), serum levels of inflammatory cytokines and stress hormones as well as peripheral blood levels of immune cells were determined.Results:At T0, serum PGE2, TNF-α, IL-6, CRP, Cor, NE, Ins, C-P and AT-II levels as well as peripheral blood IFNγ+CD4+T cell and Perforin+CD8+T cell levels were not significantly different between two groups of patients;at T1 and T2, serum PGE2, TNF-α, IL-6, CRP, Cor, NE, Ins, C-P and AT-II levels of parecoxib group were significantly lower than those of control group while peripheral blood IFNγ+CD4+T cell and Perforin+CD8+T cell levels were significantly higher than those of control group.Conclusion: Parecoxib sodium intervention before induction can inhibit inflammatory stress response and improve endocrine steady state after laparoscopic surgery.

Analgesic effect of parecoxib and flurbiprofen axetil for patients undergoing laparoscopic cholecystectomy and their influences on platelet aggregation

It is known that opioids produce postoperative analgesia, while it can also cause, especially in large doses, side effects like nausea, vomiting, constipation, syncope, skin itching, urinary retention and even respiratory inhibition. These factors have all greatly limited its clinical use for treating postoperative pain. Meanwhile, non-steroidal anti-inflammatory drugs （NSAIDs） play an increasingly important role in postoperative analgesia. Some studies suggest that NSAIDS may be neural protective in cerebral ischemic conditions.

腰椎间盘突出症经皮椎间孔镜手术麻醉诱导前应用帕瑞昔布钠超前镇痛的临床研究

目的探讨在腰椎间盘突出症经皮椎间孔镜手术麻醉诱导前应用帕瑞昔布钠超前镇痛的临床效果。方法选取70例行经皮椎间孔镜手术治疗的腰椎间盘突出症患者纳入研究,随机分为观察组及对照组,每组35例。对照组予以常规麻醉镇痛,观察组采用帕瑞昔布钠超前镇痛。比较两组患者术中不同时间[切皮时(T1)、分离肌肉韧带时(T2)、对神经根进行刺激时(T3)、缝皮时(T4)]的血流动力学指标[心率(HR)、平均动脉压(MAP)]水平,术后不同时间(术后2、6、12、24 h)的视觉模拟评分法(VAS)评分,术后不良反应发生率。结果两组T2、T3、T4时的HR、MAP水平均低于T1时,且观察组T1、T2、T3、T4时的HR水平分别为(79.63±8.26)、(75.68±7.55)、(72.17±6.49)、(70.04±5.07)次/min,低于对照组的(84.15±8.49)、(80.31±7.44)、(78.65±6.58)、(75.41±6.19)次/min,MAP水平分别为(85.44±10.43)、(77.33±10.12)、(78.65±9.88)、(79.86±9.53)mm Hg(1 mm Hg=0.133 kPa),高于对照组的(79.22±10.66)、(71.51±10.39)、(73.21±8.57)、(74.57±8.46)mm Hg(P<0.05)。观察组术后2、6、12、24 h的VAS评分分别为(2.26±0.46)、(2.86±0.68)、(3.16±0.77)、(3.79±0.94)分,低于对照组的(2.79±0.58)、(3.46±0.79)、(3.76±0.91)、(4.27±0.89)分(P<0.05)。观察组术后不良反应发生率(20.00%)高于对照组(11.43%),但差异无统计学意义(P>0.05)。结论将帕瑞昔布钠超前镇痛应用于腰椎间盘突出症患者经皮椎间孔镜手术麻醉诱导前可改善术中血流动力学,亦能有效降低术后疼痛程度,该方案安全性良好,有利于预后康复。

Preconditioning of intravenous parecoxib attenuates focal cerebral ischemia/reperfusion injury in rats

Background Several studies suggest that cyclooxygenase-2 （COX-2） contributes to the delayed progression of ischemic brain damage. This study was designed to investigate whether COX-2 inhibition with parecoxib reduces focal cerebral ischemia/eperfusion injury in rats. Methods Ninety male Sprague-Dawley rats were randomly assigned to three groups： the sham group, ischemia/reperfusion （I/R） group and parecoxib group. The parecoxib group received 4 mg/kg of parecoxib intravenously via the vena dorsalis penis 15 minutes before ischemia and again at 12 hours after ischemia. The neurological deficit scores （NDSs） were evaluated at 24 and 72 hours after reperfusion. The rats then were euthanized. Brains were removed and processed for hematoxylin and eosin staining, Nissl staining, and measurements of high mobility group Box 1 protein （HMGB1） and tumor necrosis factor-α （TNF-α） levels. Infarct volume was assessed with 2,3,5-triphenyltetrazolium chloride （TTC） staining. Results The rats in the I/R group had lower NDSs （P 〈0.05）, larger infarct volume （P 〈0.05）, lower HMGB1 levels （P 〈0.05）, and higher TNF-α levels （P 〈0.05） compared with those in the sham group. Parecoxib administration significantly improved NDSs, reduced infarct volume, and decreased HMGB1 and TNF-α levels （P 〈0.05）. Conclusions Pretreatment with intravenous parecoxib was neuroprotective. Its effects may be associated with the attenuation of inflammatory reaction and the inhibition of inflammatory mediators.

镇痛药物在膝关节置换术后的应用效果与经济学评价

目的探讨膝关节置换术后镇痛的药物疗效与经济学评价。方法选取2021年1月至2022年12月于新乡市中心医院接受膝关节置换术治疗患者180例作为研究对象,按照随机数字表法分为A组(术后接受氟比洛芬酯镇痛)、B组(术后接受帕瑞昔布镇痛)及C组(术后接受酮咯酸氨丁三醇镇痛),各60例。对比镇痛效果、视觉模拟疼痛评分(VAS)、术后首次下床时间、48 h内PCIA按压次数、膝关节活动度及不良反应发生率。结果重复测量方差分析显示,3组静息、咳嗽状态下VAS评分、膝关节活动度时间、组间及交互效应有统计学意义(P<0.05);C组T_(1)、T_(2)、T_(3)、T_(4)时点的静息、咳嗽状态下VAS评分分别低于A组和B组,而T_(0)、T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时点的膝关节活动度均高于A组和B组(P<0.05)。C组镇痛总满意度高于A组和B组(P<0.05)。C组的术后首次下床时间、48 h内PCIA按压次数均低于A组和B组(P<0.05)。C组的住院时间均短于A组和B组(P<0.05);B组和C组的住院费用、镇痛医疗成本均低于A组(P<0.05);B组的住院费用、镇痛医疗成本与C组差异无统计学意义(P>0.05)。3组不良反应总发生率差异无统计学意义(P>0.05)。结论酮咯酸氨丁三醇镇痛用于膝关节置换术后有利于减轻患者疼痛和缩短首次下床时间。

帕瑞昔布钠改善腹腔镜下直肠癌根治术患者的炎症微环境并促进患者恢复:基于下调CXCL8-CXCR1/2表达

目的研究帕瑞昔布钠对腹腔镜下直肠癌根治术患者肿瘤微环境的影响。方法选取符合纳入标准的腹腔镜下直肠癌根治术患者60例,随机分成试验组(n=30)和对照组(n=30),对照组患者于麻醉诱导时、术后即刻、术后12 h静脉注射帕瑞昔布钠40 mg;试验组患者于同样时间点静脉注射等容量的生理盐水。ELISA检测患者血浆中IL-6,TNF-α,CXCL8含量;Western blot检测患者血样外周血单个核细胞(PBMCs)中CXCL8,CXCR1和CXCR2蛋白表达;记录患者术后VAS评分、术后胃肠道不良反应、术后6个月后患者疾病转归情况。结果与试验组相比,对照组患者血浆中IL-6、TNF-α、CXCL8含量均显著减少(P<0.05),患者血样外周血单个核细胞(PBMCs)中CXCL8,CXCR1,CXCR2蛋白表达的上调程度均降低(P<0.05);与试验组相比,对照组于术后12 h、术后24 h VAS评分显著降低(P<0.05),术后发生胃肠道不良反应发生率显著下降(P<0.05);在肿瘤发生发展随访结果上,试验组发生转移或复发的患者例数高于对照组(P>0.05)。结论帕瑞昔布钠能改善腹腔镜下直肠癌根治术患者炎症微环境促进患者恢复,其机制可能与下调CXCL8-CXCR1/2表达有关。

帕瑞昔布联合舒芬太尼在腹腔镜肾癌根治术后的镇痛效应及对免疫功能的影响

目的探讨帕瑞昔布联合舒芬太尼在腹腔镜肾癌根治术后镇痛效应及其对免疫功能的影响。方法选取2018年2月至2019年6月收治的行腹腔镜肾癌根治手术治疗的晚期肾癌患者64例,随机分为对照组和研究组,每组32例。研究组于麻醉诱导前30 min静脉注射帕瑞昔布钠,对照组静脉注射0.9%氯化钠溶液,术毕清醒后立即进行舒芬太尼自控镇痛泵。对比2组患者术后镇痛前(T0)及术后镇痛6 h(T1)、12 h(T2)、24 h(T3)及48 h(T4)的视觉模拟(VAS)评分和疼痛分级法(NRS)评分、T0和T4时血流动力学指标[心率(HR)、平均动脉压(MAP)]、T0和T4时免疫功能相关指标[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)],并记录2组不良反应发生情况。结果VAS评分、NRS评分组间、时间的主效应差异有统计学意义(P<0.05),时间与组间存在交互作用(P<0.05)。T0时2组患者HR、MAP差异无统计学意义(P>0.05),与T0时相比,T4时2组患者HR、MAP均显著降低(P<0.05),且研究组HR、MAP显著低于对照组(P<0.05)。T0时2组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平差异无统计学意义(P>0.05);T4时研究组患者CD3^(+)、CD4^(+)、水平显著高于对照组(P<0.05)。用药后48 h内,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论帕瑞昔布联合舒芬太尼术后镇痛用于腹腔镜肾癌根治术患者,能达到良好的术后镇痛效果,并且能够有效改善患者术后的免疫功能,且安全性更高,值得临床推广。