Effects Of Postoperative Analgesia With Parecoxib Sodium And Fentanyl On The Immunity Of Gynecological Patients

Objective:To evaluate the effection of Parecoxib Sodium combined with Fentanyl used in PCIA after the gynecological operation; To investigate whether induce the dose and adverse reaction of opioids when combined with NSAIDs;To discuss the effection of immune recovery in gynecological patients who used Parecoxib Sodium combined with Fentanyl after operation.Methods:100 gynecological patients were randomly divided into 2 groups.Group A were intravenous injected 40mg of Parecoxib Sodium and connected with PCIA(the fentanyl 1.0mg and tropisetron 4mg were dissolved to 100ml with saline,then set the background dose was lml/h,control dose was 2ml once a time,lockout time was 15min).Group B were connected with PCIA after operation(the fentanyl 1.0mg and tropisetron 4mg were dissolved to 100ml with saline,then set the background dose was lml/h,control dose was 2ml once a time,lockout time is 15min).We observed VAS of the two groups at 4h,8h,12h,24h,48h after operation.IL-6,IL-10,T lymphocyte subsets(CD3+,CD4+,CD8+) levels and CD4+/CD8+ ratio of blood plasma were measured from peripheral venous at To,T1,T2,T3,T4,then recorded the amount of fentanyl at 48 postoperative hour,the actual number of pushing PCIA pumps,the effective number of pushing PCIA pumps and the adverse events occurred during the analgesic time.Results:1. General information There were no significant differernce of age,weight,height and oprative time between the two groups((P<0.05).2. There were no significant differernce of VAS between the two group(P<0.05).3. The adverse reaction rate of gruoup A was lower than group B, there were significant differernce between the two groups(P<0.05).4. The actual number of pushing PCIA pumps at 48 postoperative hour,the effective number of pushing PCIA pumps and the amount of fentanyl of group A were lower than group B, there were significant differernce between the two groups(P<0.05).5. There were no significant differernce between the two groups of IL-6,IL-10,T lymphocyte subsets(CD3+,CD4+,CD8+) levels and CD4+/CD8+ratio at the point of To. The IL-6, IL-10 of two groups at the point of T1,T2,T3 and T4 were higher than the IL-6, IL-10 at the point of To. there were significant differernce (P<0.05).But the IL-6 of group B were higher than group A,while the IL-10 were lower,at the point of T2,T3 and T4, there were significant differernce between the two groups(P<0.05). The level of CD3+,CD4+ were lower than T0,at the point of T1,T2,T3 and T4 of the two groups. The level of CD3+,CD4+ from group B were lower than group A (P<0.05). The CD4+/CD8+ ratio of the two groups were both lower at the point of T1,T2,T3,T4 than To,but the level of CD3+.CD4+ and CD4+/CD8+ ratio of group B were significant lower than group A at the point of T2,T3 and T4(P<0.05).The level of CD8+of group B were no significant than group A at the point of T2,T3 and T4(P<0.05).Conclusion:There were obtained good postoperative analgesia when used Parecoxib Sodium combined with Fentanyl in gynecological patients; The dose of Fentanyl was reduced;The adverse reaction, such as nausea,vomiting,pruritus, which were occurred at postoperation, were reduced;The inflammatory response after surgery was resuced,the immunosuppression was mild and the immune function were recoverd rapiddly.