Curative Effect of Parecoxib Sodium Combined with Dexmedetomidine on the Blood Glucose Insulin Cortisol and Stress Response of Patients underwent Thoracic Surgery
Guliparikelimu, ZHANG Lei, ZHU Sujie, et al
The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Urumqi 830054, China
Abstract：Objective: To study the curative effect of parecoxib sodium combined with dexmedetomidine on the blood glucose, insulin, cortisol and stress response of patients underwent thoracic surgery. Methods: 80 patients of thoracic surgery who were treated from April 2014 to April 2015 in our hospital were selected as research objects. According to the draw method, these patients were divided into the observation group and the control group, 40 cases in each group. The control group was treated with 40mg parecoxib sodium through intravenous injection at half an hour before operation, while the observation group was treated with slow injection of dexmedetomidine 0.5μg/kg at 5 minutes before the end of operation. The intraoperative hemorrhage and blood transfusion volume, recovery time of breath, waking time, extubation time, the changes of blood glucose, insulin, cortisol, epinephrine and norepinephrine, mean artery pressure (MAP), heart rate (HR), respiration rate (RR), visual analogue scale/score (VAS), ramsay score before induction (T1), at the end of operation (T2) and immediately after extubation were compared between two groups. Results: There was no significant difference in the intraoperative blood loss, intraoperative blood transfusion, recovery time, recovery time of breath and extubation time between the two groups (P>0.05); the blood glucose, insulin and cortisol levels in the observation group at T1, T2 were significantly lower than those of the control group [(5.04±0.74)mmol/L vs (6.83±0.75)mmol/L, (6.73±0.61)mmol/L vs (7.69±0.83)mmol/L, (15.59±1.89)μIU/mL vs (20.86±2.03)μIU/mL, (14.93±1.82)μIU/mL vs (17.53±1.94)μIU/mL, (370.26±62.07)nmol/L vs (560.49±70.53)nmol/L, (402.86±63.75)nmol/L vs (694.27±78.36)nmol/L](P<0.05); the epinephrine and norepinephrine levels at T1, T2 were significantly lower than those of the control group [(48.28±16.20)ng/mL vs (79.36±18.37)ng/mL, (77.39±18.20)ng/mL vs (96.38±19.75)ng/mL, (316.25±43.55)ng/mL vs (402.17±53.47)ng/mL, (398.46±54.32)ng/mL vs (475.62±56.29)ng/mL] (P<0.05); the MAP, HR at T1, T2 were significantly lower than those of the control group [(77.34±6.19)mmHg vs (84.59±6.12)mmHg, (76.40±5.89)mmHg vs (81.49±5.97)mmHg, (89.80±9.46)time /min vs (95.70±9.80)time /min, (87.57±8.09) time/min vs (94.45±8.90) time/min] (P<0.05); VAS, Ramsay scores were significantly lower than those of control group [(2.56±0.35)score vs (5.30±0.78)score, (3.63±0.90) score vs (6.42±1.08) score] (P<0.05). Conclusion: Parecoxib sodium and dexmedetomidine had a synergic role, it could reduce the blood glucose, insulin, cortisol, relieve the pain, relieve restlessness, but wouldn't cause greater stress response and was conducive to the prognosis of patients.
2018, Vol. 24 
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