Effects Of Parecoxib On Postoperative Analgesic And Cell Immunity Of Elderly Patients

Objective: Through the observation of parecoxib sodium on the postoperative analgesic and the effects on cellular immune function with elderly patients, this study wants to provide the clinical reference for the selection of types of analgesic drugs on elderly patients after operation.Methods:Select the elderly patients who came to our hospital from January 2013 to October 2014 for the open cholecystectomy as the research objects. The total number of the patients was 90 cases. According to the different types of narcotic drugs used before skin incision and after operation, the patients were randomly divided into parecoxib sodium group(35 cases), fentanyl group(33 cases) and control group(22 cases). The patients in parecoxib sodium group were given parecoxib sodium before skin incision and after operation for analgesia. The patients in fentanyl group group were given fentanyl group before skin incision and after operation for analgesia. The patients in parecoxib sodium group were given the same volume of saline before skin incision and after operation. The heart rate, mean arterial pressure, oxygen saturation were measured at different time before and after operation. The pain scores, sedation scores, restlessness score and effective number of triggers of postoperative 48 h score were measured at different time before and after operation. The T cell subpopulations were measured by flow cytometry at different time before and after operation. The data were analyzed by SPSS13.0 statistical software.Results:1. There were no statistic differences among the heart rate, mean arterial blood pressure and oxygen saturation of the three groups of patients before the operation. Compared with the results before the operation, the heart rate, mean arterial blood pressure and oxygen saturation of the three groups of patients appeared significantly increased after skin incision(T1), extubation(T2), 30 min after operation(T3), 2h after operation(T4), 4h after operation(T5). Comparison among groups, the heart rate, mean arterial pressure and oxygen saturation of the patients in parecoxib sodium group increased less than fentanyl group, three index of the control group increased the highest.2. There were no statistic differences among pain scores, sedation scores and the restlessness scores of the three groups of patients before the operation. Compared with the results before the operation, the pain scores and the restlessness scores of the three groups of patients appeared significantly decreased 2h after operation(T1), 12 h after operation(T2), 24 h after operation(T3) and 48 h after operation(T4). However, the sedation scores were increased significantly. Comparison among groups, pain scores, sedation scores, and the restlessness scores of the patients in parecoxib sodium group were the lowest. The levels of the fentanyl group followed. The three scores of the control group were the highest.3. The effective number of triggers of postoperative 48 h score of parecoxib sodium group was(1.12±0.29). The fentanyl group was(1.59±0.35). The control group was(1.86±0.43). Compared among the three groups, P<0.001. There was significant difference.4. There were no statistic differences among CD3+, CD4+, CD8+ and CD4+/CD8+ of the three groups of patients before the operation. 2h after operation, the levels of CD3-+, CD4+, CD8+ and CD4+/CD8+ of the three groups were decreased to the lowest. With the extension of time, CD3+, CD4+, CD8+ and CD4+/CD8+ appeared an rise. Comparison among groups, the decreasing amplitude of CD3+, CD4+, CD8+ and CD4+/CD8+ of the patients in parecoxib sodium group were the lowest. The decreasing amplitude of the fentanyl group followed. The decreasing amplitude of the control group were the highest.Conclusion:Parry through the study of parecoxib sodium on postoperative analgesia and cellular immune function in elderly patients, it was found that the variation amplitudes of the heart rate, mean arterial blood pressure and oxygen saturation in the parecoxib sodium group were smaller after the operation. The pain scores, the restlessness scores and the effective number of triggers of postoperative 48 h score were smaller. The sedation scores were satisfactory. Parecoxib sodium had a good protective effect on cell immunity of elderly patients.