49360
document
[ Effects of parecoxib on morphine dosage in postoperative patient-controlled analgesia following thoracoscope-assisted thoracotomy ] . OBJECTIVE To observe the effect of parecoxib on morphine dosage in patient-controlled analgesia ( PCA ) following thoracoscope-assisted thoracotomy . METHODS A consecutive series of 100 patients undergoing thoracoscope-assisted thoracotomy were randomized into 5 groups and received PCA with morphine doses at 0 , 5 , 10 , 15 , and 20 mg given in 200 ml saline ( groups P ( 1 ) , P ( 2 ) , P ( 3 ) , P ( 4 ) , and P ( 5 ) , respectively ) . Parecoxib ( 40 mg ) was given in all the patients immediately before the operation , and the mixture ( 4-5 ml ) of lidocaine and ropivacaine was administered into the 3 intercostal spaces upper and lower to the incision before chest closure . PCA was administered for each patient . The visual analogue scale ( VAS ) at rest and coughing and the respiratory functional parameters were recorded at 1 , 2 , 4 , 8 , 12 , 24 , 36 , and 48 h after the start of PCA , and the actual and effective button-pressing times ( D ( 1 ) /D ( 2 ) ) in PCA were also recorded . RESULTS No patients showed signs of respiratory inhibition within 24 h after the operation , and the resting VAS was comparable between the groups within the initial 6 postoperative hours . At 8 to 24 h postoperatively , the VAS scores at rest and coughing were significantly higher in P ( 1 ) group than in the other groups ( P < 0.05 ) , and no significant differences were found between the groups at 36 to 48 h. D ( 1 ) /D ( 2 ) in groups P ( 1 ) and P ( 2 ) were significantly different from those in the other 3 groups at 4-24 h , but no such difference was found between groups P ( 3 ) , P ( 4 ) , and P ( 5 ) . CONCLUSION The application of parecoxib may reduce the dosage of morphine in PCA following thoracoscope-assisted thoracotomy and results in good analgesic effect without affecting the patients respiratory function and sputum elimination .
49361
Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
morphine
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Intervention_Pharmacological
patient-controlled analgesia
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Intervention_Physical
thoracoscope-assisted thoracotomy
49365
Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
patient-controlled analgesia ( PCA )
49367
Intervention_Physical
thoracoscope-assisted thoracotomy
49368
Intervention_Surgical
thoracoscope-assisted thoracotomy
49369
Intervention_Pharmacological
PCA with morphine
49370
Intervention_Pharmacological
saline
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Intervention_Pharmacological
Parecoxib
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Intervention_Pharmacological
( 4-5 ml ) of lidocaine and ropivacaine
49373
Intervention_Physical
PCA
49374
Intervention_Physical
PCA
49375
Intervention_Physical
PCA
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Intervention_Pharmacological
parecoxib
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Intervention_Pharmacological
morphine
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Intervention_Physical
PCA
49379
Outcome_Physical
visual analogue scale ( VAS ) at rest
49380
Outcome_Physical
coughing and the respiratory functional parameters
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Outcome_Physical
signs of respiratory inhibition
49382
Outcome_Physical
resting VAS
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Outcome_Physical
VAS scores
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Participant_Condition
postoperative patient-controlled analgesia
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Participant_Condition
thoracotomy
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Participant_Sample-size
100 patients
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Participant_Condition
thoracoscope-assisted thoracotomy