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| Impact of preemptive analgesia of oxycodone combined with parecoxib sodium during laparoscopic hysterectomy on the perioperative stress response and serum CXC chemokine 13 and CXC chemokine receptor 5 expression levels |
| 1.General Hospital of Chinese People's Liberation Army, Beijing 100049；2.Beijing Water Conservancy Hospital |
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Abstract To analyze the impact of preemptive analgesia with oxycodone combined of parecoxib sodium during laparoscopic hysterectomy of patients on their perioperative stress response and the serum CXC chemokine 13 (CXCL13) and CXC chemokine receptor 5 (CXCR5) expression levels. Methods: 98 patients who wanted laparoscopic hysterectomy were selected and were divided into two groups according to random number table method from June 2019 to June 2021. 49 patients in the control group were given preemptive analgesia of oxycodone and 49 patients in the observation group were given preemptive analgesia of oxycodone combined with parecoxib sodium. The operation-related indicators, such as operation time, intraoperative blood loss, recovery time, and MMSE cognitive function score, the oxidative stress-related indicators, and the complications rate of the patients were compared between the two groups. The postoperative pain degree of the patients in the two groups was assessed by visual analogue scale (VAS), and the expression levels of CXCL13 and CXCR5 of the patients in the two groups were detected. Results: There were no significant differences in the operative time, the operative blood loss, the recovery time, and the MMSE cognitive function score of the patients between the two groups (P>0.05). The levels of oxidative stress indexes, such as C-reactive protein (37.14±5.32 mg/L), cortisol (165.32±18.14 nmol/L), and norepinephrine (NE) (42.16±5.27μg/L) of the patients at 24h after operation in the observation group were significantly lower than those (42.13±5.36mg/L, 177.31±17.76 nmol/L, and 49.30±5.21μg/L) of the patients in the control group. The VAS scores at 2h after operation (6.65±1.03 points), 6h after operation (5.06±0.72 points), 12h after operation (4.03±0.67 points), 24h after operation (2.34±0.61 points) and 48h after operation (0.78±0.25 points) of the patients in the observation group were significantly lower than those (7.54±1.16 points, 5.94±0.78 points and 5.03±0. 82 points, 3.54±0.74 points, and 1.55±0.42 points) of the patients in the control group. After operation, the levels of serum CXCL13 and CXCR5 of the patients in both groups were significantly lower than those before operation, and which (40.08±6.55 ng/ml and 43.28±4.46 ng/ml) of the patients in the observation group were significantly lower than those (53.43±7.24 ng/ml and 55.24±5.67 ng/ml) of the patients the control group. The complication rate (14.3%) of the patients in the observation group was significantly lower than that (38.8%) of the patients in the control group (P<0.05). Conclusion: Preemptive analgesia of oxycodone combined with parecoxib sodium during laparoscopic hysterectomy of the patients can effectively reduce their perioperative stress response and their expression levels of serum CXCL13 and CXCR5, and can increase their clinical effect with less complications.
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