The Observation On Effect Of Small Doses Of Nalmefene Or Parecoxib Sodium For Preemptive Analgesia In Esophageal Cancer Patients With Thoracic Surgery

Objective:This study focused on the effectiveness and safety applications of sufentanil and Dezocine with small doses of nalmefene or Parecoxib sodium for postoperative analgesia in esophageal cancer patients with thoracic surgery.Methods:sixty consenting esophageal cancer patients (ASA â… -â…¢) undergoing thoracic surgery under general anesthesia were entered into this Institutional Review Board-approved, randomized, double-blinded, Place-controlled study at Peace hospital affiliated Changzhi medical college, they were randomly assigned to three groups:control group, nalmefene group and parecoxib sodium group. The S group received intravenously normal saline5ml at15minutes before induction, the N group received intravenously nalmefene0.2ug/kg (diluted with5ml saline) at15minutes before induction, the P group received intravenously parecoxib40mg (diluted with5ml saline) at15minutes before induction. At the completion of surgery, sufentanil2ug/kg, Dezocine0.3mg/kg, tropisetron10mg and normal saline to total amount100ml were used for intravenous analgesia pumb (the PCIA device was programmed to the background dose2ml/h, a single dose of0.5ml, lockout time15min),3ml liquid were extracted from the pump as a loading dose intravenously at20min before surgery. We should observe and record the following index:(1)sufentanil consumption;(2)the changes include systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) at the time point after the patient into the operating room (T1),5min before extubation (T2), extubation (T3),5min after extubation (T4) in each group;(3)the comparison of postoperative eye opening time and extubation time;(4)VAS analgesia score, BCS score at times of0h,4h,8h,12h,24h,48h after the surgery;(5)the PCIA total pressing number, valid pressing times and adverse events at24h and48h after the surgery. Results:1.compared with S and P group,the consumption of intraoperative sufentanil was significantly reduced in the N group.Compared with group S, the change of blood pressure and heart rate were also reduced in anesthesia extubation period in the N and P groups, there was no statistically significant difference in group N and group P. Compared with group N, the eye opening time and extubation time were significantly prolonged in the P and S groups,there was no statistically significant difference in group P and group S.2.Compared with the S group, the VAS was decreased in the N and P groups after0h,4h,8h,12h,24h, and the difference was statistically significant; compared with the N group, the VAS score was increased only at12h after the surgery, with the rest of the time with no significant difference compared with the N group, the VAS of the three groups were no significant difference at48h after the surgery. Compared with the S group, the BCS was increased in the N and P groups after0h,4h,8h,12h,24h,48h, and the difference was statistically significant.3.Compared with group S, the PCIA total pressing number and valid pressing times are significantly reduced in the N and P groups at24h and48h after the surgery, and there was no significant difference between the N and P groups. Adverse effects were no significant differences among the three groups.Conclusions:1.Pre-emptive of parecoxib sodium40mg in thoracic esophageal resection can enhance postoperative analgesia and reduce the consumption of postoperative analgesia drug.2. Pre-emptive of small doses of nalmefene can reduce the intraoperative sufentanil consumption, It has the same analgesic effect as parecoxib sodium in the recovery period, It can shorten eye opening time and extubation time, enhance postoperative analgesia and reduce the consumption of postoperative analgesia drug.