Parecoxib Sodium Reduces The Incidence Of Postoper Ative Cognitive Dysfunction In Elderly Patients By Maintaining Normal Blood-brain Barrier Permeability

Objective:To observe the effect of parecoxib sodium on postoperative cognitive dysfunction in elderly patients,and deeply explore and improve the mechanism of its protective effect.Methods:Select 80 patients(65-79 years old)for elective lumbar fusion surgery.The gender,age,BMI,disease and drug use,and ASA classification of the patients were recorded.The patients were randomly divided into 2 groups(n=40): the control group(S group)and the experimental group(P group),of which 6 patients refused to draw blood,and 1 patient was discharged early.Group P: Dissolve 40 mg parecoxib sodium in 10 ml NS and inject it slowly 30 minutes before the operation.Group S:Inject the same volume of normal saline slowly half an hour before the operation,and record the blood pressure,heart rate,blood loss and operation time.MMSE score,VAS score,SIRS score were evaluated on the 1st day before operation(T0),1st day after operation(T1),2nd day after operation(T2),3rd day after operation(T3),and the patients were sampled at the same time venous blood,check the white blood cell count and S100β level.Results:There was no significant difference in gender,age,BMI,disease and drug use,and ASA classification between group S and P group(P>0.05).There was no significant difference in blood loss and operation time between S group and P group(P>0.05).There was no significant difference in preoperative(T0)MMSE score,VAS score,SIRS score,white blood cell count and S100β level between group S and group P(P>0.05);compared with group S,group P patients on the first day after surgery(T1)There was no significant difference in the white blood cell count(P=0.679),and the white blood cell count decreased significantly on the second day(T2)and the third day(T3)after the operation(P<0.05).Compared with the s group,the MMSE score of group P was increased on the first day(T1),the second day(T2),the third day(T3),and the VAS score,SIRS score and S100 β level were significantly decreased(P < 0.05).Conclusion:Preoperative application of parecoxib sodium can relieve postoperative pain in elderly patients,reduce inflammation,and reduce the incidence of postoperative cognitive dysfunction;The effect of improving postoperative cognitive dysfunction is related to maintainined the normal permeability of the BBB.