The Effects And Security Of Parecoxib Sodium With The Patients Of Kidney Transplantation

Objective:To evaluate the safety of parecoxib sodium used in patients undergoing renal transplantation, and its efficacy in analgesia.Methods:48 patients with ASA III-IV, aged 18-60yr, BMI (Body Mass Index)≤28.0kg/m2, no history of heart failure nor liver function abnormal. They were randomly divided into P group (Parecoxib Sodium group), F group (Fentanyl group) and N group (control group), n=16. General anesthesia was used to all the patients, and trachea cannul under anesthesia induction with midazolam 0.04mg/kg, fentanyl 4ug/kg, etomidate 0.3mg/kg and cis-atracurium 0.2mg/kg. During the surgery, anesthesia was maintained with propofol, remifentanil and cis-atracurium. P group received intravenous parecoxib 40mg before surgery finished, F group received intravenous fentanyl 0.1mg, while N group received intravenous normal saline 2ml as control. Mean arterial pressure (MAP), pulse oxygen saturation (SPO2), heart rate (HR) and central venous pressure (CVP) were monitored at the time point of 5 minutes before extubation (T1), tracheal extubation (T2),5 minutes after extubation (T3),10 minutes after extubation (T4), and recorded whether there was cough, nausea, vomiting or sedation assessment meanwhile in order to evaluate initial VAS score. Patients were transferred to intensive care unit 15 minutes after extubation. Serum creatinine in venous blood (Cr) and blood urea nitrogen (BUN) were detected 12h and 36h before the surgery and another time at 36h after the surgery. Urine was recorded within 12 hours and 36 hours after the surgery, too.Results:There was no significant difference in ages, sex, weight, days in hospital, length of operation and intraoperative transfusion volume (P>0.05). In F group, the difference between T3, T4 and T1 on pulse oximetry makes sense, P<0.05. In N group, compared with T1, systolic blood pressure at T2, T3, T4 was significantly different, P<0.05. In P group, there was no significant difference between T2, T3, T4 and T1 on hemodynamics, P>0.05. The differences in anesthesia and comparison of hemodynamic among the three groups were apparent, P<0.05. The efficiency of sedation and analgesia scores are significant different among the three groups, P<0.05. Divergences in cough, restlessness, nausea, vomiting, and effeciency of postoperative analgesic in three groups are visible, P<0.05. Urine 12 and 36 hours after operation had no statistical difference in three groups, P> 0.05. There is no statistical difference in renal function through the evaluation of Cr and BUN, P>0.05.Conclusion:40mg Parecoxib Sodium can be used for intravenous analgesia after renal transplantation, no adverse effects on renal function. It is expected to do well in both analgesia and sedation with little side effects.