Preemptive Analgesic Effect of Parecoxib in Patients Undergoing Inguinal Hernia Repair_West China Medical Journal

Authors：

 SONGYing-han , MADong-yang , LUAn-qing , XIEYan-yan , GUODong-jiao , YELi-na , LIKe-shu ,  LEIWen-zhang

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LEIWen-zhang, Email: leiwz9@163.com

Keywords：

Preemptive analgesia; Parecoxib sodium; Hernioplasty; Prostaglandin E₂

DOI：

10.7507/1002-0179.20150251

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Objective To evaluate the preemptive analgesic efficiency of parecoxib on patients undergoing inguinal hernia repair. Methods One hundred and twenty patients scheduled for surgery between May and August 2013 were randomized into group A (n=60) and group B (n=60). Patients in group A received intravenous parecoxib sodium (40 mg) for 45 minutes before surgery while group B received equivalent normal saline. All patients underwent tension-free hernia repair under local anesthesia with simplex lidocaine. Visual analogy scores (VAS) after surgery and the maximum VAS were recorded. The number of patients requiring rescue analgesic (tramadol injection) or with adverse effects related to analgesia were observed and recorded. Postoperative hospital stay and patient satisfaction score with analgesic effect were compared between the two groups. Concentrations of plasma prostaglandin E₂(PGE₂) before surgery and 24 hours after surgery were measured in both groups. Results VAS scores were significantly lower in group A at 2, 4, 8 and 12 hours after surgery than group B, while no significant difference was seen after 24 hours of the surgery. The number of patients requiring tramadol (3/60) or with adverse effects (2/60) in group A were significantly lower than that in group B (11/60 and 8/60 respectively). Postoperative hospital stay was shorter while patient satisfaction score with analgesic effect was higher in group A than in group B. There were no significant differences in concentration of plasma PGE2 between the two groups before surgery and after 24 hours of the surgery (P>0.05). Conclusion Preemptive administration of parecoxib for hernia repair can result in significant analgesic effect with fewer adverse effects, higher patient satisfaction and faster recovery.

Citation： SONGYing-han, MADong-yang, LUAn-qing, XIEYan-yan, GUODong-jiao, YELi-na, LIKe-shu, LEIWen-zhang. Preemptive Analgesic Effect of Parecoxib in Patients Undergoing Inguinal Hernia Repair. West China Medical Journal, 2015, 30(5): 873-876. doi: 10.7507/1002-0179.20150251 Copy

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13.	江亞, 段廷明, 吳剛, 等. 氟比洛芬酯帕瑞昔布及曲馬多用于骨科創傷手術后鎮痛效果的研究[J]. 河北醫學, 2011, 17(9):1206-1208.
14.	Ng A, Smith G, Davidson AC. Analgesic effects of parecoxib following total abdominal hysterectomy[J]. Br J Anaesth, 2003, 90(6):746-749.
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1. 徐建國. 成人術后疼痛治療進展[J]. 臨床麻醉學雜志, 2011, 27(3):299-301.
2. Woolf CJ, Chong MS. Preemptive analgesia:treating postoperative pain by preventing the establishment of central sensitization[J]. Anesth Analg, 1993, 77(2):362-379.
3. 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.
4. 王慶, 李真, 王志鵬, 等. 帕瑞昔布鈉在腹腔鏡結腸癌根治術中的超前鎮痛作用[J]. 南方醫科大學學報, 2010, 30(11):2556-2557, 2561.
5. 廖小卒, 李斌飛, 程周, 等. 帕瑞昔布鈉超前鎮痛聯合Narcotrend在宮腔手術中的應用[J]. 華西醫學, 2013(8):1222-1224.
6. Song Y, Han B, Lei W, et al. Low concentrations of lidocaine for inguinal hernia repair under local infiltration anaesthesia[J]. J Int Med Res, 2013, 41(2):371-377.
7. Crile GW, Lower WE. Anoci-Association[M]. Philadelphia:Saunders, 1914:223-225.
8. Ong CS, Lirk P, Seymour RA, et al. The efficacy of preemptive analgesia for acute postoperative pain management:a meta-analysis[J]. Anesth Analg, 2005, 100(3):757-773.
9. Dahl JB, Mathiesen O, M?iniche S. "Protective premedication":an option with gabapentin and related drugs? A review of gabapentin and pregabalin in in the treatment of post-operative pain[J]. Acta Anaesthesiol Scand, 2004, 48(9):1130-1136.
10. Jung YS, Kim MK, Um YJ, et al. The effects on postoperative oral surgery pain by varying NSAID administration times:comparison on effect of preemptive analgesia[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 100(5):559-563.
11. 姚乃修, 顏學軍. 氟比洛芬酯超前鎮痛聯合異丙酚、瑞芬太尼靜脈麻醉在小兒疝修補術中的應用[J]. 南京醫科大學學報:自然科學版, 2009, 29(4):562-563.
12. 連鐵, 魯愛民, 李太富, 等. 曲馬多超前鎮痛應用于小兒腹腔鏡疝修補術的觀察[J]. 海南醫學, 2004, 15(6):75-76.
13. 江亞, 段廷明, 吳剛, 等. 氟比洛芬酯帕瑞昔布及曲馬多用于骨科創傷手術后鎮痛效果的研究[J]. 河北醫學, 2011, 17(9):1206-1208.
14. Ng A, Smith G, Davidson AC. Analgesic effects of parecoxib following total abdominal hysterectomy[J]. Br J Anaesth, 2003, 90(6):746-749.
15. Solca M. Acute pain management:unmet needs and new advances in pain management[J]. Eur J Anaesthesiol Suppl, 2002, 25:3-10.
16. Coruzzi G, Menozzi A, Dobrilla G. Novel non-steroidal anti-inflammatory drugs:what we have learned from animal studies[J]. Curr Drug Targets Inflamm Allergy, 2004, 3(1):43-61.
17. Fornai M, Colucci R, Graziani F, et al. Cyclooxygenase-2 induction after oral surgery does not entirely account for analgesia after selective blockade of cyclooxygenase 2 in the preoperative period[J]. Anesthesiology, 2006, 104(1):152-157.
18. 王雅琴, 寧寧, 何凌霄, 等. 快速康復外科理念在胃腸外科中的應用進展[J]. 華西醫學, 2012, 27(1):155-157.

West China Medical Journal

Preemptive Analgesic Effect of Parecoxib in Patients Undergoing Inguinal Hernia Repair

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