The Observation On Effect Of Sufentanil With Parecoxib Sodium For Postoperative Self-controlled Intravenous Analgesia In Patients With Thoracic Surgery

In recent years, because of synergy between non-steroidal anti-inflammatory drugs (NSAIDs) and opioids and the reduction of the dosage of opioids and the incidence of adverse reactions, NSAIDs has become an important adjuvant for postoperative analgesia and is widely used postoperative balanced nanlgesia.Parecoxib sodium is newly parenteral form of a COX-2 selective inhibitor for intravenous administration, It is an amide pro-drug that is rapidly hydrolysed in vivo to the active form, valdecoxib, a COX-2 selective inhibitor. Many clinical studies in oral surgery, gynecology surgery and orthopedics surgery have confirmed that parecoxib sodium is effective for postoperative analgesia, however, whether it is effective for postoperative analgesia safely for thoracic surgery is unknown at home and abroad. Therefore, my study is designed to evaluate whether parecoxib combined with sufentanil is improve postoperative pain or reduce the comsumption of sufentanil and related side effects in thoracic surgery.Materials and MethodsForty cosenting patients undergoing thoracic surgery were entered into this In-stitutional Review Board-approved, randomized, double-blinded, place-controlled study at China Medical University, Study entry criteria included body weight 50--80kg, age30-65yr, ASAⅠ-Ⅱwere randomly assigned to parecoxib group and co-ntrol group. The study of drug-parecoxib sodium 40mg/support (provided by Ph-armacia, according to random numbers, parecoxib sodium 40mg was dissolved in-to normal colorless and transparent solution that looks like saline solution, or con-troll drug normal saline 2ml for research use.After receiving a standardized general anesthetic technique consisting of midaz- olam 2mg, sufentanil 0.4ug/kg, propofol 1-1.5mg/kg, rocuronium 0.6mg/kg for ind-uction, and sevoflurane 1.5-2.5%, sufentanil and cis-atracurium for mainternance of anesthesia, granisetron 3mg were given at the end of surgery, at the completion of s-urgery, sufentanil 0.04/ug/kg/h were used for intravenous analgesia pumb (the PCA d-evice was programmed to deliver 1.6 bolus does of sufentanil, load dose 2ml, the bac-kground dose 1.2ml/h with lock-out interval of 20 min, the use of time is 72h. praeco-xib group:parecoxib 40 mg at induction and parecoxib 40 mg 12 h after induction; Control group:normal saline at induction and 12 h after induction. The observation in-dex is sufentanil consumption at 6 h,24 h and 48 h after operation; the number of uns-atisfied demand and the number of successfully delivered doses; the pain scores with movement at 6 h,24 h and 48 h after operation using a visual analogscale and treatm-ent side effects; the patients'global evaluation of the 24 h postoperation analgesia we-re recorded and compared between the two groups.ResultsThe two groups were comparable with respect to age and body weight. The sufent-anil consumption at 6 h,24 h and 48 h after operation was significantly less in pareco-xib group than in control group and was reduced by 22.60%(at 6 h),23.75%(at 24 h) and 17.23%(at 48 h) respectively. The number of unsatisfied demand and successfully delivered doses at 24 h and 48 h after operation were significantly lower in parecoxib group than in control group(P＜0.01), The M-VAS scores at 6 h,24 h,48 h were signi ficantly lower in parecoxib group than in control group(P<0.05). The percentage of t--he patient who considered the postoperative analgesia'excellent'or'good'was85% in parecoxib group and 75% in control group. Overall adverse effects of patients receivi-ng parecoxib and sufentanil were comparable to those receiving sufentanil alone.ConclusionThe use of sufentanil combined with parecoxib resulted in analgesia with less suf-entanil consumption as compared with sufentanil alone in PCIA for patients after th-oracic surgery, and impove postoperative analgesia.