Influence of different time of administration of parecoxib in three doses method on postoperative analgesia of gallbladder stones

ObjectiveTo explore the effects of different time of administration of parecoxib three doses method on postoperative analgesia of gallbladder stones.

MethodsOne hundred and fifty-two patients with gallbladder stones were investigated using a prospective randomized controlled study, and divided into the control group and observation group according to random number table method(76 cases in each group). Two groups were treated with laparoscopic cholecystectomy. The control group was given parecoxib empirically for 40 mg once after surgery, the patients with incision pain were given the medicine one more time, and the total dose was not more than 80 mg a day. The observation group was given parecoxib three doses method after 0 h, 8 h and 16 h of surgery, 20 mg each time for postoperative analgesia. The serum stress-related factors norepinephrine(NE), blood glucose(Glu), cortisol(Cor), pain degree(VAS score), sedationRamsay sedation score, agitation(Riker-SAS agitation score), cognitive function(MMSE score), incidence rates of adverse reactions(including nausea, pruritus, vomiting, flatulence, edema at injection site), postoperative painless time of getting out of bed, morphine dosage, length of hospital stay, total hospitalization cost and patient's satisfaction between two groups before operation(T₀), and at postoperative 3 h(T₁), postoperative 9 h(T₂) and postoperative 18 h(T₃) were compared.

ResultsAt T₁, T₂ and T₃, the serum levels of NE, Glu and Cor in two groups were higher than those at T₀(P < 0.05), but those in observation group were lower than those in control group(P < 0.01). The VAS scores in observation group at T₁, T₂ and T₃ were lower than that in control group(P < 0.01). At T₁ and T₂, the Ramsay sedation score in observation group was higher than that in control group, and lower than that at T₃(P < 0.01). The Riker-SAS agitation score in observation group at T₁ and T₂ were lower than that in control group, and which in observation group at T₃ was higher than that in control group(P < 0.01). The total incidence rate of adverse reaction in observation group was lower than that in control group(P < 0.05). Compared with the control group, the postoperative painless time of getting out of bed and hospitalization time in observation group were shorter(P < 0.01), and the amount of use morphine and total hospitalization cost in observation group were lower than those in control group(P < 0.01). The satisfaction of postoperative analgesia in observation group was higher than that in control group(P < 0.05).

ConclusionsThe parecoxib three doses method can significantly reduce the serum levels of stress-related factors, improve the effect of analgesia and sedation, reduce the incidence rate of adverse reactions, promote the postoperative recovery of patients and reduce the amount of morphine and total hospitalization costs, which has high patient's satisfaction.