Pain Management Using Perioperative Administration of Parecoxib for Total Hip Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial.

医学 帕雷昔布 可视模拟标度 麻醉 围手术期 随机对照试验 安慰剂 临床试验 止痛药 外科 前瞻性队列研究 吗啡 内科学 病理 替代医学
作者
Ke Xiao,Lingjia Yu,Weiyuan Xiao,Xisheng Weng,Yanyan Bian,Zhihong Wu,Weng Xi-sheng
出处
期刊:PubMed 卷期号:22 (6): 575-582 被引量:11
链接
标识
摘要

Controlling postoperative pain and improving outcomes after total hip arthroplasty (THA) remain an important challenge, which affects the functional recovery of the hip.To assess the effect of preemptive administration of the selective cyclooxygenase-2 inhibitor parecoxib sodium (PS) after THA.A prospective, randomized, double-blinded clinical trial.An academic medical center.This randomized double-blind clinical trial compared postoperative analgesia intervention for unilateral primary THA. Patients were assigned in a 1:1 ratio to the PS group and the control group. The PS group received 40 mg dose of PS 30 minutes before incision, 12 hours after THA, and every 12 hours for 2 days postoperatively, and the control group received normal saline solution at the same time point. In addition, both groups received patient-controlled intravenous analgesia of morphine. Perioperative visual analog scale (VAS) scores, cumulative morphine consumption, functional recovery, perioperative bleeding risk, and the selected indicators of the inflammatory response were compared between the PS group and the control group.From October 2014 to June 2015, 180 patients undergoing unilateral primary THA were screened for this prospective clinical trial. A total of 141 patients were enrolled and randomly assigned into the PS group (n = 69) and the control group (n = 72). Compared with the control group, VAS scores at rest were significantly lower in the PS group at 4, 12, and 24 hours after surgery, and VAS scores during movement were also lower in the PS group at 4, 12, 24, 36, and 48 hours after surgery (all P < 0.001). Both the cumulative morphine consumption and its associated nausea and vomiting were reduced in the PS group (P < 0.001 and P = 0.021, respectively). The length of hospitalization in the PS group was shorter than the control group (PS group 5.91 ± 1.15 days, control group 6.41 ± 1.49 days; P = 0.019). The PS group had lower body temperature than the control group at postoperative day (POD) 1 (P = 0.003) and POD 3 (P = 0.001), and the levels of high-sensitivity C-reactive protein in the PS group at POD 3 (P = 0.016) and POD 6 (P = 0.006) were also lower than those in the control group. The concentration of interleukin (IL)-6 and IL-10 were significantly different between the 2 groups (IL-6, P = 0.007; IL-10, P = 0.006) on the first day postoperatively. The PS group was not significantly different from the control group with respect to any outcomes: blood loss, postoperative blood drainage and blood transfusion, and number of days needed to accomplish straight-leg raising and off-bed exercise.PS was used only until POD 2, and there was no long-term follow-up.Perioperative administration of PS is an effective addition to a multimodal regimen that alleviates postoperative pain, reduces the cumulative morphine consumption, length of hospitalization, and perioperative inflammatory response, without increasing perioperative bleeding risk.Parecoxib sodium, multimodal analgesia, total hip arthroplasty, inflammatory response.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Hover完成签到,获得积分0
刚刚
莫晓岚完成签到,获得积分10
刚刚
123完成签到 ,获得积分10
1秒前
所所应助JSY采纳,获得30
1秒前
默默的立辉完成签到,获得积分10
1秒前
Yh完成签到,获得积分10
1秒前
引子完成签到,获得积分10
3秒前
机智的阿振完成签到,获得积分10
4秒前
KatzeBaliey完成签到,获得积分10
5秒前
量子星尘发布了新的文献求助10
6秒前
yar应助大饼采纳,获得10
7秒前
mammer应助一朵云采纳,获得20
7秒前
7秒前
Jason完成签到,获得积分10
8秒前
害羞凤灵完成签到,获得积分10
8秒前
芳芳完成签到,获得积分10
9秒前
风起枫落完成签到 ,获得积分10
9秒前
xkhxh完成签到 ,获得积分10
10秒前
zzq778发布了新的文献求助10
10秒前
小马甲应助双儿采纳,获得10
11秒前
江南烟雨如笙完成签到 ,获得积分10
12秒前
王洋应助枕星采纳,获得10
15秒前
笨笨寒天完成签到,获得积分10
15秒前
Hello应助zzq778采纳,获得10
15秒前
16秒前
铜豌豆完成签到 ,获得积分10
16秒前
稞小弟完成签到,获得积分10
16秒前
17秒前
19秒前
19秒前
zzzz发布了新的文献求助10
20秒前
小马完成签到,获得积分10
22秒前
22秒前
一朵云完成签到,获得积分10
23秒前
JSY发布了新的文献求助30
24秒前
浩铭完成签到,获得积分10
25秒前
Iven发布了新的文献求助10
25秒前
27秒前
29秒前
冷酷的天晴完成签到,获得积分10
29秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038368
求助须知:如何正确求助?哪些是违规求助? 3576068
关于积分的说明 11374313
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029