Influence of parecoxib combined with tramadol on perioperative pain and inflammatory cytokines after video-assisted thoracic lobectomy
Huang Lelin
Tu Chenggang
Abstract：Objective To explore the influence of parecoxib combined with tramadol on perioperative pain and inflammatory cytokines after video-assisted thoracic lobectomy.Methods Totally 96 patients undergoing video-assisted thoracic lobectomy from May 2012 to May 2015 were randomly divided into control group (48 cases) and observation group (48 cases).Control group was given intravenous injection of 4 ml 0.9％ sodium chloride 10 min before anesthesia induction,intravenous injection of 2 ml 0.9％ sodium chloride solution + 2 mg/kg tramadol 30 min before the end of operation;observation group was given intravenous injection of 40 mg parecoxib 10 min before anesthesia induction,intravenous injection of 20 mg parecoxib + 2 mg/kg tramadol 30 min before the end of operation.Anesthesia was induced and maintained with remifentanil and propofol in both groups.The recovery time,operation duration,anesthesia duration,mean arterial pressure (MAP) and heart rate during recovery were recorded;the levels of interleukin (IL)-6 and IL-8 in serum before operation,immediately,6,12,24 h after operation were measured;the visual analog scale score (VAS) was assessed 15 min,1 h,2 h,4 h and 12 h after operation;the adverse reactions were observed.Results The surgery was successfully completed in all the patients.The remifentanil usage in observation group was significantly less than that in control group [(0.67 ± 0.12) mg vs (1.18 ± 0.17) mg] (P ＜ 0.05);the operative duration,anesthesia duration and recovery time was not significantly different between groups (P ＞ 0.05).The MAP and heart rate in observation group were significantly lower than those in control group immediately,5 and 10 after extubation [MAP:(80 ± 3) mmHg vs (102±5) mmHg,(80±4) mmHg vs (97 ±5) mmHg,(80 ±4) mmHg vs (96±5) mmHg,1 mmHg=0.133 kPa;heart rate:(72.1 ±2.1) times/min vs (91.8 ±3.6) times/min,(71.3 ±2.3) times/min vs (90.7 ±3.4) times/min,(71.7 ±2.2) times/min vs (90.5 ±3.1) times/min] (P ＜0.05).The levels of IL-6 and IL-8 was significantly increased immediately,6,12 and 24 h after operation compared with those before operation in control group [IL-6:(147 ±20),(208 ±41),(269 ±67),(185 ±26) ng/L vs (56 ± 10) ng/L;IL-8:(1.60 ±0.50),(2.19 ±0.59),(2.36 ±0.63),(1.69 ±0.37) μg/L vs (0.93 ±0.25) μg/L] and observation group [IL-6:(112 ± 17),(139 ±25),(227 ±49),(121 ±20) ng/L vs (57 ±9) ng/L;IL-8:(1.22 ± 0.39),(1.51 ±0.42),(1.60±0.39),(1.30 ±0.28) μg/L vs (0.95 ±0.24) μg/L],while they were significantly lower in observation group than those in control group (all P ＜ 0.05).The VAS score in observation group was significantly lower than that in control group 15 min,1 h,2 h,4 h,12 h after operation [(1.2 ± 0.3) scores vs (3.1 ± 0.4) scores,(1.2 ± 0.5) scores vs (2.7 ± 0.7) scores,(1.5 ± 0.6) scores vs (3.3 ± 0.9) scores,(2.6 ± 0.6) scores vs (4.2 ± 1.1) scores,(3.5 ± 0.9) scores vs (5.6 ± 1.0) scores] (P ＜0.05).The incidence of adverse reactions was not significantly different between groups (P ＞ 0.05).Conclusion Pre and intraoperative application of parecoxib combined with tramadol has significant analgesic effect,and can reduce the usage of postoperative analgesics,inhibit the inflammation in video-assisted thoracic lobectomy.
Keywords：Video-assisted thoracic surgery lobectomyParecoxibTramadolPainInflammatory cytokines
Publication Date：2016-04-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 515-519 )