Effects Of Parecoxib Sodium Multimodal Analgesia On Gynecologic Laparotomy Surgery

ObjectivesTo investigate the effects of parecoxib sodium multimodal analgesia on gynecologic laparotomy surgery.MethodsForty-five ASA(American Society of Anesthesiologists) I-II patients, scheduled for surgery aging from 30 to 60. Excluded standards: patients with contraindication of intravertebral anesthesia; patients with history of allergy to food or drugs; patients with history of drug and alcool; patients with peptic ulcer or hemorrhage of digestive tract; patients with serious hepatic, renal, cardiac or pulmonary diseases; patients with inflammatory bowel disease; patients with cognitive dysfunction; patients during pregnancy and lactation; patients took analgesic or sedative recent period. They were divided into three groups randomly. Group A was composed of fifteen patients undergoing parecoxib sodium 40 mg intravenous(i.v.); Patients of group B undergoing butorphanol 2 mg i.v.; and patients of group C undergoing normal saline 2 ml i.v..They were added by intravenous injection before 15 min of operation.When patients entered operating room,we opened wenous access and monitored vital sign. Anesthesia methods:combined spinal-epidural anesthesia (CSEA) in L2/3,gave the mixed solution of 10% glucose solution (GS) and 0.75% bupivacaine injection, and gave 0.75% ropivacaine injection when the operation needed.All of patients stoped inject drug to epidural before 30 min of end of operation. Patients used PC A (Patient Controlled Analgesia) when operation finished and measured VAS(Visual Analogue Scale/Score) after 2h,4h,6h,12 and 24h, recorded dosage of PC A after 24h and adverse reaction.Results1. There were no differences in patients'age, weight, time of operation (P>0.05).Patients'vital sign were stable and they did not used other medicine after operation.2. VAS of group A and B compared with C was lower in 2h,4h,6h(P <0.05),but there was no differences in 12h and 24h (P>0.05).Group A and B have not contrast(P>0.05).3. The dosage of fentanyl was differences among three group(P< 0.05). Group B was the fewest and C was the most.4. Group A and B were lower than C as to the incidence of adverse reaction(P<0.05).Conclsion:1. Gynecologic laparotomy surgery used parecoxib sodium before operation could reduce VAS and there were no differences compare with butorphanol.2. Gynecologic laparotomy surgery used parecoxib sodium before operation could decrease dosage of PCA.This effect of butorphanol was superior than parecoxib sodium.3. Gynecologic laparotomy surgery used parecoxib sodium before operation could reduce incidence of adverse reaction for opioids.