Objective: To investigate the effect of parecoxib sodium preemptive analgesia on pain and stress response after surgery in elderly hip fracture patients.
Methods: The clinical data of 70 elderly patients with hip fracture treated in our hospital from October 2017 to October 2019 were prospectively analyzed. According to different analgesic patterns, 35 cases were randomly divided into experimental group, aged 65 to 86(78.5±9.1) years, 21 males and 14 females, including 18 femoral neck fractures and 17 femoral intertrochanteric fractures. There were 35 cases in control group, aged 66 to 88 (80.6±8.1) years, 18 males, and 17 females, including 20 cases of femoral neck fractures and 15 cases of intertrochantericfractures. The visual analogue scale (VAS) at 4 h, 12 h, 24 h, 48 h, and 72 h after surgery, the incidence of delirium and stress indicators of malondialdehyde (MDA), superoxide dismutase (SOD), cortisol (COR), and epinephrise (E) postoperatively in the two groups were observed.
Results: At 4 h, 12 h, 24 h, 48 h after surgery, the VAS score of experimental group was lower than that of the control group, and the difference was statistically significant (P<0.05). There was no statistical difference between the two groups at 72 h postoperatively (P>0.05). Within 72 h after surgery, the dosage of indomethacin suppository (0.1 g/suppository) in experimental group was 0.3 g, and that in control group was 1.2 g, the dosage of experimental group was less than that of control group. Within 7 days after operation, delirium occurred in 2 cases(5.7%) in experimental group and 8 cases (22.8%) in control group, the incidence of delirium in experimental group was significantly lower than that in the control group (χ2=4.2, P= 0.040). Two days after surgery, the serum SOD content of the two groups of patients increased, and the levels of MDA, E, and COR decreased; and the serum MDA, E, and COR levels of experimental group were lower than control group, and the SOD content was higher than control group;the differences were statistically significant (χ2<0.05).
Conclusion: The advanced analgesic application of parecoxib sodium can significantly reduce the postoperative stress response of elderly hip fracture patients, enhance the postoperative analgesic effect, reduce the incidence of postoperative delirium, and improve the quality of rehabilitation of patients.
Keywords: Aged; Analgesia; Hip fractures.