Abstract
Objective To observe the preventive effects of parecoxib sodium on occurring of emergence agitation during the recovery period of general anesthesia for the patients who underwent epigastric surgeries.Methods one hundred and twenty patients,ASA Ⅰ ~ Ⅱ,underwent elective epigastic surgeries were divided randomly into four groups,30 cases in each group.Anesthesia of all patients was maintained with sevoflurane and remifentanil,keeping the bispectral index (BIS) around 40-50.Parecocib 0.8 mg/kg was intravenously infused into the patients just before anesthesia induction in group A and just before the closure of peritoneum in group B,Sufentanil 0.08 μg/kg was injected just before the closure of peritoneum in group C,2 ml saline as placebo was administrated in group D.The level of agitation(RS),visual analogue scales(VAS) and ramsay sedation score(RSS) were evaluated during the recovery period of general anesthesia.Mean arterial pressure(MAP) and heart rate(HR)were monitored at preinduction (T1),10 min before tracheal extubation (T2),immediately after tracheal extubation (T3) and 10 min after tracheal extubation (T4).Results The recovery time of group A,B,D(7±3),(8±4),(7±3) min is significantly shorter than that of group C.Requirement of remifentanil in group A (0.8±0.3) mg is significantly lower than that of group D (1.3±0.5) mg (P<0.05).At T3,the MAP and HR in group D(126±25) mmHg(1 mmHg=0.133 kPa)(106±28) beats/min were significantly higher than those in group A [(106±25) mmHg,(96±25) beats/min],group B [(113±27) mmHg,(99±27) beats/min],group C [(111±27) mmHg,(86± 19) beats/min](P<0.05),which happened similarly at T4.Compared with group D,the incidence of agitation (33.3%) is significantly higher than that of group A (6.7%),group B (13.2%) and group C (10.0%) (P<0.05),and the incidence of agitation group A is significantly lower than group B (P<0.05).Compared with group D,the median of score of VAS is 5,which is significantly higher than that of group A (2),group B (3),and group C (2) (P<0.05),Compared with group D,the median of score of RSS is 4,which is significantly higher than that of group A (3),group B (3) and group C (3) respectively (P<0.05).The incidence of nausea and vomiting of group C is much higher than other groups significantly (P<0.05).Conclusions Parecoxib sodium has an analgesic effect for the patients of epigastric surgeries,preventing the incidence of postoperative agitation and adverse reactions during the recovery period of general anesthesia. Key words: Parecoxib; Postoperative agitation ; Side effect
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