title: [Effect of cycloxygenase 2 inhibitor on levels of prostaglandin E2 in plasma and in local infiltrated fluid after functional endoscopic sinus surgery].
abstract: OBJECTIVE
  To examine the time course and clinical relevance of changes in prostaglandin E2 (PGE2) to pain and outcome in surgical drainage, and circulating blood after functional endoscopic sinus surgery (FESS).
  
  
  METHODS
  Thirty-seven patients scheduled to undergo FESS were randomized to receive celecoxib 400 mg(n=16) one hour before anesthesia induction and celecoxib 200 mg, q12 h for five consecutive days after surgery or nothing for patients in control group(n=21). Surgical site drainage and venous blood were collected up to 48 hours after surgery to test PGE2 level. Plasma levels of thromboxane A2 (TXA2) and prostacyclin (PGI2) were also tested for the same time course.
  
  
  RESULTS
  For control patients, PGE2 level was elevated in both surgical site and circulating blood, which reached a peak concentration 6 h(177.5 ± 142.2 ng/L) and 48 h (64.5 ± 21.4 ng/L)respectively after FESS. For patients in celecoxib group, a significant reduction of surgical drainage PGE2(peak level 106.2 ± 33.4 ng/L at 6 h) and plasma PGE2 (peak level 44.7 ± 30.2 ng/L at 48 h) was observed(P<0.05). Pain scores 6 h and 48 h after surgery were positively correlated with surgical drainage PGE2 level, correlation coefficient being 0.333 (P=0.044) and 0.353(P=0.032) respectively. Celecoxib did not affect the ratio of plasma TXA2 to PGI2.
  
  
  CONCLUSIONS
  Upregulation of PGE2 in surgical site after surgery was crucial in inflammatory response and postoperative pain. Cycloxygenase-2 inhibitor could significantly reduce surgical drainage and plasma PGE2 concentration.
authors.affiliation: Department of Anesthesiology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhao
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Feng
authors.forename: Ba-xian
authors.initials: BX
authors.lastname: Yang
authors.forename: Zhi-min
authors.initials: ZM
authors.lastname: Xing
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.forename: Li-shen
authors.initials: LS
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000068579:Celecoxib; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D015232:Dinoprostone / Q000097:blood / Q000378:metabolism*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D059747:Nasal Surgical Procedures; D009668:Nose Diseases / Q000097:blood / Q000188:drug therapy / Q000601:surgery; D010149:Postoperative Pain / Q000517:prevention & control*; D011720:Pyrazoles / Q000627:therapeutic use*; D012852:Sinusitis / Q000097:blood / Q000188:drug therapy / Q000601:surgery*; D013449:Sulfonamides / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib; D015232:Dinoprostone