Effects of Parecoxib Sodium Preemptive Analgesia on Postoperative Inflammatory Cytokines and Stress Responses in Elderly Patients Undergoing Total Hip Replacement_West China Medical Journal

Authors：

 CHENWei ,  LIWei , XIEDong-wu , RAOQing , WANGJian

Department of Anesthesiology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

LIWei, Email: lw5955@163.com

Keywords：

Preemptive analgesia; Parecoxib sodium; Cytokine; Stress response; Hip replacement

DOI：

10.7507/1002-0179.20150306

Video：

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Objective To investigate whether parecoxib sodium preemptive analgesia reduces inflammatory cytokines and stress hormones production in elderly patients after total hip replacement. Method Sixty patients with American Society of Anesthesiologists Classification Ⅰ-Ⅱ undergoing total hip replacement for femoral neck fracture or aseptic necrosis of the femoral head, aged between 60 and 90 years with a body weight more than 50 kg, were randomly divided into preemptive analgesia group (group P, n=30) and control group (group C, n=30). The patients in group P received parecoxib sodium 40 mg intravenously 30 min before skin incision, and another 20 mg 8 hours after the first administration. All the patients in the two groups received the administration of patient-controlled analgesia sufentanyl. We recorded blood levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), cortisol (COR), adrenaline (AD) and noradrenaline (NAD) 30 min before skin incision, and 1 hour, 6 hours, 12 hours and 24 hours postoperatively. Results The blood levels of IL-6, TNF-α, COR, AD and NAD in group P at 1 hour, 6 hours, 12 hours or 24 hours postoperatively were significantly lower than those in group C (P<0.05). Conclusions Parecoxib sodium preemptive analgesia reduces postoperative inflammatory cytokines and stress hormones production in elderly patients undergoing total hip replacement.

Citation： CHENWei, LIWei, XIEDong-wu, RAOQing, WANGJian. Effects of Parecoxib Sodium Preemptive Analgesia on Postoperative Inflammatory Cytokines and Stress Responses in Elderly Patients Undergoing Total Hip Replacement. West China Medical Journal, 2015, 30(6): 1067-1070. doi: 10.7507/1002-0179.20150306 Copy

1.	Martinez V, Belbachir A, Jaber A, et al. The influence of timing of administration on the analgesic efficacy of parecoxib in orthopedic surgery[J]. Anesth Analg, 2007, 104(6):1521-1527, table of contents.
2.	金惠銘, 盧建, 殷蓮華. 細胞分子病理生理學[M]. 鄭州:云南科技出版社, 1997:430.
3.	梅曉亮, 郭亭, 趙建寧. 全髖關節置換術后血清炎性因子表達特點及臨床意義[J]. 中國骨傷, 2011, 24(6):463-465.
4.	Bjornsson GL, Thorsteinsson L, Gudmundsson KO, et al. Inflammatory cytokines in relation to adrenal response following total hip replacement[J]. Scand J Immunol, 2007, 65(1):99-105.
5.	Peng M, Wang YL, Wang FF, et al. The cyclooxygenase-2 inhibitor parecoxib inhibits surgery-induced proinflammatory cytokine expression in the hippocampus in aged rats[J]. J Surg Res, 2012, 178(1):e1-e8.
6.	李秀澤, 李衛, 夏氫. 帕瑞昔布鈉超前鎮痛在小兒上肢骨折手術中的臨床研究[J]. 華西醫學, 2011, 26(8):1189-1191.
7.	Bunyavejchevin S, Prayoonwech C, Sriprajittichai P. Preemptive analgesic efficacy of parecoxib vs placebo in infertile women undergoing diagnostic laparoscopy:randomized controlled trial[J]. J Minim Invasive Gynecol, 2012, 19(5):585-588.
8.	陳偉, 李衛, 謝東武, 等. 帕瑞昔布鈉在老年胃癌根治術圍術期多模式鎮痛中的應用[J]. 實用醫院臨床雜志, 2014, 11(2):52-55.
9.	Nong L, Sun Y, Tian Y, et al. Effects of parecoxib on morphine analgesia after gynecology tumor operation:a randomized trial of parecoxib used in postsurgical pain management[J]. J Surg Res, 2013, 183(2):821-826.
10.	Wei W, Zhao T, Li Y. Efficacy and safety of parecoxib Sodium for acute postoperative pain:a meta-analysis[J]. Exp Ther Med, 2013, 6(2):525-531.
11.	Shuying L, Xiao W, Peng L, et al. Preoperative intravenous parecoxib reduces length of stay on ambulatory laparoscopic cholecystectomy[J]. Int J Surg, 2014, 12(5):464-468.
12.	Guo YJ, Shi XD, Fu D, et al. Analgesic effects of the COX-2 inhibitor parecoxib on surgical pain through suppression of spinal ERK signaling[J]. Exp Ther Med, 2013, 6(1):275-279.
13.	Bao Y, Fang J, Peng L, et al. Comparison of preincisional and postincisional parecoxib administration on postoperative pain control and cytokine response after total hip replacement[J]. J Int Med Res, 2012, 40(5):1804-1811.
14.	Pandazi A, Kapota E, Matsota P, et al. Preincisional versus postincisional administration of parecoxib in colorectal surgery:effect on postoperative pain control and cytokine response. A randomized clinical trial[J]. World J Surg, 2010, 34(10):2463-2469.
15.	Gold JR, Cohen ND, Welsh TH. Association of adrenocorticotrophin and cortisol concentrations with peripheral blood leukocyte cytokine gene expression in septic and nonseptic neonatal foals[J]. J Vet Intern Med, 2012, 26(3):654-661.
16.	Bunn SJ, Ait-Ali D, Eiden LE. Immune-neuroendocrine integration at the adrenal gland:cytokine control of the adrenomedullary transcriptome[J]. J Mol Neurosci, 2012, 48(2):413-419.
17.	Lindholm E, Seljeflot I, Aune E, et al. Proinflammatory cytokines and complement activation in salvaged blood from abdominal aortic aneurism surgery and total hip replacement surgery[J]. Transfusion, 2012, 52(8):1761-1769.
18.	Zhu Y, Wang S, Wu H, et al. Effect of perioperative parecoxib on postoperative pain and local inflammation factors PGE2 and IL-6 for total knee arthroplasty:a randomized, double-blind, placebo-controlled study[J]. Eur J Orthop Surg Traumatol, 2014, 24(3):395-401.
19.	Bastian D, Tamburstuen MV, Lyngstadaas SP, et al. Systemic and local cytokine kinetics after total hip replacement surgery[J]. Eur Surg Res, 2008, 41(4):334-340.

1. Martinez V, Belbachir A, Jaber A, et al. The influence of timing of administration on the analgesic efficacy of parecoxib in orthopedic surgery[J]. Anesth Analg, 2007, 104(6):1521-1527, table of contents.
2. 金惠銘, 盧建, 殷蓮華. 細胞分子病理生理學[M]. 鄭州:云南科技出版社, 1997:430.
3. 梅曉亮, 郭亭, 趙建寧. 全髖關節置換術后血清炎性因子表達特點及臨床意義[J]. 中國骨傷, 2011, 24(6):463-465.
4. Bjornsson GL, Thorsteinsson L, Gudmundsson KO, et al. Inflammatory cytokines in relation to adrenal response following total hip replacement[J]. Scand J Immunol, 2007, 65(1):99-105.
5. Peng M, Wang YL, Wang FF, et al. The cyclooxygenase-2 inhibitor parecoxib inhibits surgery-induced proinflammatory cytokine expression in the hippocampus in aged rats[J]. J Surg Res, 2012, 178(1):e1-e8.
6. 李秀澤, 李衛, 夏氫. 帕瑞昔布鈉超前鎮痛在小兒上肢骨折手術中的臨床研究[J]. 華西醫學, 2011, 26(8):1189-1191.
7. Bunyavejchevin S, Prayoonwech C, Sriprajittichai P. Preemptive analgesic efficacy of parecoxib vs placebo in infertile women undergoing diagnostic laparoscopy:randomized controlled trial[J]. J Minim Invasive Gynecol, 2012, 19(5):585-588.
8. 陳偉, 李衛, 謝東武, 等. 帕瑞昔布鈉在老年胃癌根治術圍術期多模式鎮痛中的應用[J]. 實用醫院臨床雜志, 2014, 11(2):52-55.
9. Nong L, Sun Y, Tian Y, et al. Effects of parecoxib on morphine analgesia after gynecology tumor operation:a randomized trial of parecoxib used in postsurgical pain management[J]. J Surg Res, 2013, 183(2):821-826.
10. Wei W, Zhao T, Li Y. Efficacy and safety of parecoxib Sodium for acute postoperative pain:a meta-analysis[J]. Exp Ther Med, 2013, 6(2):525-531.
11. Shuying L, Xiao W, Peng L, et al. Preoperative intravenous parecoxib reduces length of stay on ambulatory laparoscopic cholecystectomy[J]. Int J Surg, 2014, 12(5):464-468.
12. Guo YJ, Shi XD, Fu D, et al. Analgesic effects of the COX-2 inhibitor parecoxib on surgical pain through suppression of spinal ERK signaling[J]. Exp Ther Med, 2013, 6(1):275-279.
13. Bao Y, Fang J, Peng L, et al. Comparison of preincisional and postincisional parecoxib administration on postoperative pain control and cytokine response after total hip replacement[J]. J Int Med Res, 2012, 40(5):1804-1811.
14. Pandazi A, Kapota E, Matsota P, et al. Preincisional versus postincisional administration of parecoxib in colorectal surgery:effect on postoperative pain control and cytokine response. A randomized clinical trial[J]. World J Surg, 2010, 34(10):2463-2469.
15. Gold JR, Cohen ND, Welsh TH. Association of adrenocorticotrophin and cortisol concentrations with peripheral blood leukocyte cytokine gene expression in septic and nonseptic neonatal foals[J]. J Vet Intern Med, 2012, 26(3):654-661.
16. Bunn SJ, Ait-Ali D, Eiden LE. Immune-neuroendocrine integration at the adrenal gland:cytokine control of the adrenomedullary transcriptome[J]. J Mol Neurosci, 2012, 48(2):413-419.
17. Lindholm E, Seljeflot I, Aune E, et al. Proinflammatory cytokines and complement activation in salvaged blood from abdominal aortic aneurism surgery and total hip replacement surgery[J]. Transfusion, 2012, 52(8):1761-1769.
18. Zhu Y, Wang S, Wu H, et al. Effect of perioperative parecoxib on postoperative pain and local inflammation factors PGE2 and IL-6 for total knee arthroplasty:a randomized, double-blind, placebo-controlled study[J]. Eur J Orthop Surg Traumatol, 2014, 24(3):395-401.
19. Bastian D, Tamburstuen MV, Lyngstadaas SP, et al. Systemic and local cytokine kinetics after total hip replacement surgery[J]. Eur Surg Res, 2008, 41(4):334-340.

West China Medical Journal

Effects of Parecoxib Sodium Preemptive Analgesia on Postoperative Inflammatory Cytokines and Stress Responses in Elderly Patients Undergoing Total Hip Replacement

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