title: [Effects of parecoxib on morphine dosage in postoperative patient-controlled analgesia following thoracoscope-assisted thoracotomy].
abstract: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. xiaojinfang718@163.com
authors.forename: Jin-fang
authors.initials: JF
authors.lastname: Xiao
authors.forename: Gao-wang
authors.initials: GW
authors.lastname: Liu
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Liu
authors.forename: Xiao-min
authors.initials: XM
authors.lastname: Hou
authors.forename: Miao-ning
authors.initials: MN
authors.lastname: Gu
mesh_terms: D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000188:drug therapy*; D013906:Thoracoscopy; D013908:Thoracotomy / Q000379:methods*; D055815:Young Adult
chemical_list: D007555:Isoxazoles; D009020:Morphine; C409945:parecoxib