Effects of Hydromorphone combined with Parecoxib Sodium on analgesia in patients with coronary heart disease undergoing non-cardiac thoracic surgery
Objective To investigate the effects of Hydromorphone combined with Parecoxib Sodium on analgesia in patients with coronary heart disease undergoing non-cardiac thoracic surgery.Methods A total of 138 patients with coronary heart disease who underwent non-cardiac thoracic surgery in Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from September 2020 to September 2022 were selected,and they were divided into group A,group B,and group C using random number table method,with 46 patients in each group.All three groups underwent surgery under general anesthesia,group A was given Hydromorphone combined with Parecoxib Sodium,group B was given Parecoxib Sodium,and group C was given Hydro-morphone.The mean arterial pressure(MAP),heart rate(HR),and respiratory rate(RR)among three groups were compared 5 min before extubation(T0),immediately after extubation(T1),5 min after extubation(T2),and 10 min after extubation(T3);visual analogue scale(VAS)scores were compared at 4,12,24 h,and 72 h after surgery among three groups;the effective compression times of patient-controlled intravenous analgesia(PCIA)24 h after surgery were compared among three groups;Prostaglandin E2(PGE2),neuropeptide Y(NPY),adrenocortical hormone(ACTH),aldosterone(ALD),and C-peptide(C-P)were compared before surgery and 12,72 h after surgery among three groups;and the occurrence of adverse reactions among three groups were recorded.Results Overall comparison:there were statistically significant differences between groups,time,and interaction of MAP,HR,and RR among three groups(P＜0.05).Further pairwise comparison,intra-group comparison:at T1-T3,MAP and HR among three groups were higher than those at T0,and RR was lower than that at T0,and the differences were statistically significant(P＜0.05).Comparison between groups:at T1-T3,MAP and HR in group A were lower than those in group B and group C,and RR was higher than those in group B and group C,and the differences were statistically significant(P＜0.05).Overall comparison:there were statistically significant differences between groups,time,and interaction of VAS at cough and rest among three groups(P＜0.05);further pairwise comparison,intra-group comparison:12,48 h,and 72 h after surgery,the VAS scores at cough and rest among three groups were lower than those at 4 h after surgery,and the differences were statistically significant(P＜0.05);comparison between groups:4,12 h after surgery,VAS scores at cough and rest in group A were lower than those in group B and group C,and the differences were statistically significant(P＜0.05).The compression times of PCIA 24 h after surgery in group A was lower than that in group B and group C,and the differences were statistically significant(P＜0.05).Overall comparison:there were statistically significant differences between groups,time,and interaction of the levels of PGE2,NPY,ALD,C-P,and ACTH among three groups(P＜0.05);further pairwise comparison,intra-group comparison:12 h after surgery,the levels of PGE2,NPY,ALD,C-P,and ACTH among three groups were higher than those before surgery,and the differences were statistically significant(P＜0.05);comparison between groups:12 h after surgery,the levels of PGE2,NPY,ALD,C-P,and ACTH in group A were lower than those in group B and group C,and the differences were statistically significant(P＜0.05).There was no significant difference in the total incidence of adverse reactions between group A and group B(P＞0.05);there was no significant difference in the total incidence of adverse reactions between group A and group C(P＞0.05).Conclusion Hydromorphone combined with Parecoxib Sodium can relieve postoperative pain in patients with coronary heart disease undergoing non-cardiac thoracic surgery,regulate endocrine and circulatory function,and have high safety.
万方数据
维普
