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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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.	李秀泽, 李卫, 夏氢. 帕瑞昔布钠超前镇痛在小儿上肢骨折手术中的临床研究[J]. 华西医学, 2011, 26(8):1189-1191.
4.	王庆, 李真, 王志鹏, 等. 帕瑞昔布钠在腹腔镜结肠癌根治术中的超前镇痛作用[J]. 南方医科大学学报, 2010, 30(11):2556-2557, 2561.
5.	廖小卒, 李斌飞, 程周, 等. 帕瑞昔布钠超前镇痛联合Narcotrend在宫腔手术中的应用[J]. 华西医学, 2013(8):1222-1224.
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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, 颜学军. 氟比洛芬酯超前镇痛联合异丙酚、瑞芬太尼静脉麻醉在小儿疝修补术中的应用[J]. 南京医科大学学报:自然科学版, 2009, 29(4):562-563.
12.	连铁, 鲁爱民, 李太富, 等. 曲马多超前镇痛应用于小儿腹腔镜疝修补术的观察[J]. 海南医学, 2004, 15(6):75-76.
13.	江亚, 段廷明, 吴刚, 等. 氟比洛芬酯帕瑞昔布及曲马多用于骨科创伤手术后镇痛效果的研究[J]. 河北医学, 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, 宁宁, 何凌霄, 等. 快速康复外科理念在胃肠外科中的应用进展[J]. 华西医学, 2012, 27(1):155-157.

1. 徐建国. 成人术后疼痛治疗进展[J]. 临床麻醉学杂志, 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. 李秀泽, 李卫, 夏氢. 帕瑞昔布钠超前镇痛在小儿上肢骨折手术中的临床研究[J]. 华西医学, 2011, 26(8):1189-1191.
4. 王庆, 李真, 王志鹏, 等. 帕瑞昔布钠在腹腔镜结肠癌根治术中的超前镇痛作用[J]. 南方医科大学学报, 2010, 30(11):2556-2557, 2561.
5. 廖小卒, 李斌飞, 程周, 等. 帕瑞昔布钠超前镇痛联合Narcotrend在宫腔手术中的应用[J]. 华西医学, 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, Møiniche 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, 颜学军. 氟比洛芬酯超前镇痛联合异丙酚、瑞芬太尼静脉麻醉在小儿疝修补术中的应用[J]. 南京医科大学学报:自然科学版, 2009, 29(4):562-563.
12. 连铁, 鲁爱民, 李太富, 等. 曲马多超前镇痛应用于小儿腹腔镜疝修补术的观察[J]. 海南医学, 2004, 15(6):75-76.
13. 江亚, 段廷明, 吴刚, 等. 氟比洛芬酯帕瑞昔布及曲马多用于骨科创伤手术后镇痛效果的研究[J]. 河北医学, 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, 宁宁, 何凌霄, 等. 快速康复外科理念在胃肠外科中的应用进展[J]. 华西医学, 2012, 27(1):155-157.

West China Medical Journal

Preemptive Analgesic Effect of Parecoxib in Patients Undergoing Inguinal Hernia Repair

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