Comparative Study On Analgesic Effect Of Parecoxib Combined With Different Dosages Of Butorphanol For Postoperative PCIA In Patient With Laparoscopic Appendectomy

Objective:To compare the analgesic effect of parecoxib combined with different dosages of butorphanol for patient-controlled intravenous analgesia(PCIA)in patients undergoing laparoscopic appendectomy(LA).Methods:90 randomly selected ASA physical status I or II patients,who aged from 19 to 59 years old,weighted from 44 to 92 kg and scheduled for laparoscopic appendectomy were enrolled in the study.General anesthesia was induced with midazolam 0.03mg/kg intravenously(i.v.),sufentanil 0.5ug/kg(i.v.),propofol 1-2mg/kg(i.v.),cisatracurium 0.15mg/kg(i.v.).After accessory excessive ventilation for 3 minutes,anesthesiologist performed trachaeal intubation.15 minutes before surgery,each patient received parecoxib 40mg(i.v.),and they were randomly assigned to group A(butorphanol 8mg),group B(butorphanol 10mg),group C(butorphanol 12mg)for PCIA.The resting/motor VAS scores,Ramsay scores,and BCS scores were recorded at 6 different time points(1h(T1),4h(T2),8h(T3),12h(T4),24h(T5),and 48h(T6)after surgery).The first time of farting,off-bed activity,the total pressing times of the PCIA button,the adverse reaction,and the patients' satisfactions of PCIA were recorded after surgery.Result:1.All 3 groups of patients could obtain satisfactory analgesia.Compared with group B and C,the resting status VAS scores ranging from T3 to T5 were significantly higher in group A(P<0.05),while there were no significant difference between group B and C(P>0.05).The motor status VAS scores at any time point ranging from T2 to T5 showed A>B>C(P<0.05).Compared with group A and B,the Ramsay scores ranging from T2 to T4 were significantly higher in group C(P<0.05),while there were no significant difference between group A and B(P>0.05).The BCS scores ranging from T2 to T5 showed C>B>A(P<0.05).The total press times of PCIA pump within 48 h showed A>B>C(P<0.05),and the number of patients who were given remedial analgesic drugs showed no significant difference among the three groups(P>0.05).2.There were no significant difference of the first fart time after operation among the three groups(P>0.05).Group B patients took less time to finish off-bed activity than group A and C(P<0.05).3.The rate of adverse reaction in group C patients was higher than group A and B,including somnolence and dizziness.4.Compared with group A,the patients' satisfactions of PCIA were better in group B and C,while there were no significant difference between group B and C(P>0.05).Conclusion:40mg parecoxib combined with 10 mg butorphanol showed less adverse reaction,made patients more safe and comfortable.And patients were more satisfied with this strategy.