Effects of parecoxib sodium on plasm concentration of prostaglandin E2 and patient-controlled analegsia in patients after laparoscopic gastrectomy

Abstract

Objective To investigate the effect of parecoxib sodium on levels of prostaglandin E2 (PGE2) in plasm and patient-controlled analegsia (PCA) after laparoscopic gastrectomy.Methods Ninety gastric cancer patients scheduled for elective laparoscopic gastrectomy accepting PCA were randomly divided into 2 groups:control group (group S) and parecoxib sodium grou (group P).Group S received intravenous normal saline (5 ml) 30 min before incision and 8 h after operation respectively.Group P received intravenous parecoxib sodium (40 mg) 30 min before incision and 8 h after operation respectively.Venous blood samples were collected 30 min before incision (T1),2 h after surgery beginning (T2) and 12 h after operation (T3) to test PGE2 concentrations.The visual analogue scale (VAS) for assessing resting and motion pain at 12,24 and 48 h after operation,the consumption of sufentanil,effective number of PCA,the side effects and patient satisfaction were recorded.Results The levels of PGE2 were significantly lower at T2 in group S and group P than at T1 (P ＜ 0.05),higher at T3 (P ＜ 0.05).As compared with group S,the levels of PGE2 at T2(135.95 ± 30.27 vs.147.78 ± 19.70) and at T3 (168.03 ±29.15 vs.182.61 ± 28.36) were significantly lowered in group P (P ＜ 0.05).The resting VAS of pain at 12 h after operation in group P and group S was separately 12.73 ± 12.41 and 23.64 ± 15.29 (P ＜0.05),abd the motion VAS of pain was 13.18 ± 13.14 and 23.63 ± 15.29 (P ＜0.05).The resting VAS of pain at 24 h after operation in group P and group S was separately 10.00 ± 8.73 and 17.27 ± 9.84 (P ＜ 0.05),and the motion VAS of pain wase 10.90 ± 8.11 and 17.27 ± 9.844 (P ＜ 0.05).The effective number of PCA was significantly less in group P than in group S (P ＜ 0.05).No significant differences were found between two groups at the side effects (P ＞ 0.05).The patient satisfaction was better in group P than in group S (P ＜ 0.05).Conclusion Parecoxib sodium could siginificantly suppress the production of PGE2 and improve the effect of PCA after laparoscopic gastrectomy. Key words: Parecoxib sodium; Prostaglandin E2 ; Patient-controlled analegsia; Laparoscopy ; Gastrectomy