• Zhonghua yi xue za zhi · Jul 2013

    Randomized Controlled Trial

    [Effects of parecoxib sodium analgesia on serum concentrations of neuron-specific enolase and S-100β and postoperative cognitive function of elderly patients undergoing acute replacement of femoral head].

    • Jing-zhu Li, Xiao-zheng Li, Xiao-min Wang, Ming-shan Wang, Hai-fang Yu, Fei Shi, Dan Miao, and Yan-lin Bi.
    • Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao 266071, China.
    • Zhonghua Yi Xue Za Zhi. 2013 Jul 16;93(27):2152-4.

    ObjectiveTo explore the effects of parecoxib sodium analgesia on serum concentrations of neuron-specific enolase (NSE) and S-100β and postoperative cognitive function of elderly patients undergoing acute replacement of femoral head.MethodsAfter the approval of institutional review board and the provision of informed consent, 80 patients over 70 years old, undergoing acute replacement of femoral head under combined spinal and epidural anesthesia and midazolam sedation at Qingdao Municipal Hospital and Qingdao Hiser Medical Center from January 2011 to May 2012, were randomly assigned into control group (group C, n = 40) and parecoxib group (group P, n = 40). In group P, parecoxib sodium 20/40 mg (based on weight 50 kg) was administered via an intravenous injection after admission with 12 hours intervals for six times. In group C, morphine 2/4 mg was given initially. Additional morphine 2 mg was given to maintain the pain visual analog scale (VAS) of 3 points or less in both groups. Primary observation indices: (1) postoperative time and additional amount of morphine; (2) rate of postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) at 3 days, 1 week, 3 months and 6 months postoperation (T1-T4); (3) se rum levels of NSE and S-100β were measured at the timepoints of before analgesia (t0), before anesthesia (t1), end of surgery (t2) and 6 hours, 24 hours, 48 hours postoperation (t3-t5); (4) other serious complications.ResultsCompared with group C, the additional amount of morphine, postoperative time, rate of POD and POCD at T1-T4, the level of NSE at t2-t5 and S-100β at t1-t5 were lower in group P (P < 0.05). No other serious complications were observed.ConclusionsParecoxib sodium analgesia reduces the rate of POD and POCD in elderly patients with neuroprotective effects.

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