title: Effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma.
abstract: BACKGROUND
  To investigate the effects of preemptive analgesia with parecoxib sodium on haemodynamics and plasma stress hormones in surgical patients with thyroid carcinoma.
  
  
  METHODS
  Fifty-seven patients with thyroid carcinoma who underwent thyroidectomy selectively in Laiwu Hospital Affiliated to Taishan Medical University and Binzhou People's Hospital were selected and randomly divided into three groups, 19 cases in each group. The control group was intravenously injected 0.9% sodium chloride injection before anesthesia induction; trial group I was intravenously injected with parecoxib sodium 20 min before anesthesia induction; based on trial group I, trial group II was injected with parecoxib sodium again 12 h after surgery. The levels of plasma norepinephrine (NE), cortisol (Cor) and blood glucose before, 12 and 24 h after surgery and changes of haemodynamics before surgery, at the end of surgery and 12, 24 and 48 h after surgery were compared in the three groups. Besides, visual analogue scale (VAS) scores were recorded 4, 8, 12 and 24 h after surgery.
  
  
  RESULTS
  12 and 24 h after surgery, the levels of plasma NE and Cor in three groups rose dramatically (P<0.05 or (P<0.01); The levels of plasma NE and Cor in trial groups I and II were evidently lower than in control group (P<0.05 or P<0.01), and those in trial group II slightly lower than in trial group I. 12 h after surgery, the heart rates (HR) and systolic pressures (SBP) in trial groups I and II increased obviously by comparison to surgery before (P<0.05 or P<0.01), but gradually returned to the preoperative level. HR, SBP and diastolic pressures (DBP) in trial groups I and II at the end of surgery and 12 h after surgery were all lower than in the control group, and significant differences were present (P<0.05 or (P<0.01). At 4, 8, 12 and 24 h after surgery, VAS scores in trial groups I and II were markedly lower than in the control group ((P<0.05 or (P<0.01), the scores in trial group II being the lowest.
  
  
  CONCLUSIONS
  Combined application of parecoxib sodium for preemptive analgesia before anesthesia and after surgery can effectively reduce the levels of plasma stress hormones and improve analgesic effects in surgical patients with thyroid carcinoma, and without conspicuous impact on haemodynamics.
authors.affiliation: Department of General Surgery, Laiwu Hospital Affiliated to Taishan Medical University, Laiwu, China E-mail : suhaiwen999@126.com.
authors.forename: Lian-Dong
authors.initials: LD
authors.lastname: Wang
authors.forename: Xia
authors.initials: X
authors.lastname: Gao
authors.forename: Jun-Ying
authors.initials: JY
authors.lastname: Li
authors.forename: Hong-Yan
authors.initials: HY
authors.lastname: Yu
authors.forename: Hai-Wen
authors.initials: HW
authors.lastname: Su
authors.forename: Lian-Zhong
authors.initials: LZ
authors.lastname: Liu
authors.forename: Jun
authors.initials: J
authors.lastname: Qi
mesh_terms: D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007555:Isoxazoles / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009638:Norepinephrine / Q000097:blood*; D011379:Prognosis; D013964:Thyroid Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy
chemical_list: D001786:Blood Glucose; D052246:Cyclooxygenase 2 Inhibitors; D007555:Isoxazoles; C409945:parecoxib; D006854:Hydrocortisone; D009638:Norepinephrine