关键词: 帕瑞昔布钠, 肾移植, 术后疼痛, 术后镇痛, 血流动力学

Abstract: Abstract:Objective To determine the effect and safety of parecoxib sodium on pos
toperative analgesia in patients after renal transplantation,and to provide basi
s for application of analgesia medicine for patients after renal transplantation.
Methods Forty-eight patients underwent renal allogeneic transplantation were randomly
divided into parecoxib sodium group,fentanyl group,and control group,and there
were 16 patients in each group.The patients in three groups were given parecoxib
 sodium 40 mg,fentanyl 0.2 mg and saline 2 mL,respectively.The hemodynamic  parameters of patients in various groups were recorded at  5 min before e
xtubation(T1),extubation time(T2),5 min after extubation(T3) and 10 min after extubation(T4);and the occurrence of  cough,nausea and vomiting of patients
 were recorded;the postoperative pain and sedation levels were evaluated;the urine output,the levels of serum creatinine(SCr) and blood urea nitrogen (BUN) of
 patients in various groups before operation and 12,36 h after operation were compared.
Results There were no significant differences of operation time,intraoperative
infusion amount and hospitalization time of patients between various groups (P> 0.05).
Compared with T1 time point,the  SBP  levels of patients at T2,T3 and T4 in control group were increased(P<0.05);compared with T1 time point,the levels of oxygen sa
turation (SpO2)of patients at T3 and T4 in fentanyl group were decreased(P<0.05).There were no significant differences of
hemodynamic parameters of patients in parecoxib sodium group at T1,T2,T3 and T4 time points(P> 0.05).
Compared with control group,the incidence rates of tussis and dysphoria of patients in parecoxib sodium group and fentanyl
 group were decreased(P<0.05);there were no siginificant differences of the incidence rates of nausea and vomiting between var
ious groups(P>0.05).Compared with control group,the using times of tramadol hydrochloride  of patients in parecoxib sodium
group and fentanyl group were decreased.There was also no siginificant difference of urine volume,serum BUN,and SCr of
 patients between  various groups before and after operation (P>0.05).There was also  no siginificant difference of postoperative analgesia between fentanyl group and control group(P>0.05).The scores of postoperative analgesia of patients in parecoxib sodium group were lower than those in the other groups(P<0.05);the scores of postoperative sedation of patients in fentanyl group was lower than those in the other groups(P<0.05).
Conclusion Parecoxib sodium can be a candidate drug for postoperative  pain relief in patients underwent  renal transplantation,which has fewer side effects.

Key words: parecoxib sodium, renal transplantation, postoperative pain, postoperative analgesia, hemodynamics