title: [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].
abstract: OBJECTIVE
  To 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.
  
  
  METHODS
  After 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.
  
  
  RESULTS
  Compared 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.
  
  
  CONCLUSIONS
  Parecoxib sodium analgesia reduces the rate of POD and POCD in elderly patients with neuroprotective effects.
authors.affiliation: Department of Anesthesiology, Qingdao Municipal Hospital, Qingdao 266071, China.
authors.forename: Jing-zhu
authors.initials: JZ
authors.lastname: Li
authors.forename: Xiao-zheng
authors.initials: XZ
authors.lastname: Li
authors.forename: Xiao-min
authors.initials: XM
authors.lastname: Wang
authors.forename: Ming-shan
authors.initials: MS
authors.lastname: Wang
authors.forename: Hai-fang
authors.initials: HF
authors.lastname: Yu
authors.forename: Fei
authors.initials: F
authors.lastname: Shi
authors.forename: Dan
authors.initials: D
authors.lastname: Miao
authors.forename: Yan-lin
authors.initials: YL
authors.lastname: Bi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000698:Analgesia / Q000379:methods*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D059408:Pain Management; D010751:Phosphopyruvate Hydratase / Q000097:blood*; D011184:Postoperative Period; D064568:S100 Calcium Binding Protein beta Subunit / Q000097:blood
chemical_list: D007555:Isoxazoles; D064568:S100 Calcium Binding Protein beta Subunit; C579160:S100B protein, human; C409945:parecoxib; D010751:Phosphopyruvate Hydratase