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Analgesic effects of 2 nonsteroidal anti-inflammatory drugs respectively combined with hydromorphone in postoperative analgesia after thoracic surgery: a randomized, double blind, controlled clinical study



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Analgesic effects of 2 nonsteroidal anti-inflammatory drugs respectively combined with hydromorphone in postoperative analgesia after thoracic surgery: a randomized, double blind, controlled clinical study


YAN Guangming CHEN Jie YANG Guiying DUAN Guangyou DU Zhiyong YU Zubin PENG Jing LIAO Wei LI Hong

Department of Anesthesiology,Department of Thoracic Surgery, Second Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China


nonsteroidal anti-inflammatory drugs inflammatory cytokines patient controlled intravenous analgesia thoracoscopic surge

R614.24; R656; R971.1

Objective   To compare the postoperative analgesic effects of parecoxib and flurbiprofen axetil combined with hydromorphone respectively on the patients undergoing elective thoracoscopic surgery, and determine the effects on inflammation and postoperative pulmonary complications. Methods    A total of 156 patients who underwent elective thoracoscopic surgery and then received postoperative patientcontrolled intravenous analgesia (PCIA, 0.15 mg/kg hydromorphone+0.6 mg ramosetron diluted with saline to 200 mL, infusion speed: 4 mL/h, single PCA dose: 1 mL, and lock time: 15 min) in our hospital from February to November 2017 were prospectively enrolled in this study. They were randomly divided into 3 groups according to the intraoperative analgesic agents they received, that is, 40 mg parecoxib sodium (group A), 50 mg flurbiprofen (group B) and  5 mL normal saline (group C), which were intravenously injected in 30 min before the end of surgery. Numerical rating scale (NRS) of postoperative pain and adverse reactions at 6, 12, 24, 48 h after the operation, postoperative pulmonary complications, inflammatory cytokines (C-reaction protein, white cell count, and percentage of neutrophils) and blood gas analysis at 12 h postoperatively and length of hospital stay were recorded and compared between the 2 groups. Results    Compared with group C, the NRS score was significantly lower in group A and group B at 6 and 12 h after operation (P<0.05), and that of group B was lower than that of group A though no statistical difference (P>0.05). The serum C-reaction protein level at 3 d after operation was significantly decreased in groups A and B than group C (P<0.05), and the level of group B was lower than that of group A but there was no significant difference (P>0.05). No significant differences were found in the scores of nausea and vomiting and the incidence of postoperative pulmonary complications in the intragroup and intergroup comparison (P>0.05). Compared with group C, the mean length of hospitalization was significantly shorter in group B (P<0.05), and there was no significant difference between group A and group C and between group A and group B (P>0.05), though the length was 1.32 d shorter in group B than group A.  Conclusion     Application of both parecoxib sodium or flurbiprofen axetil in 30 min before the end of surgery can enhance the analgesic effect of hydromorphone after thoracoscopic surgery, reduce inflammation and help patients recover after operation. However, flurbiprofen axetil seems to be better than parecoxib sodium.


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Last Update: 2018-06-14