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07 February 2019 : Clinical Research  

Effectiveness of Parecoxib Sodium Combined with Transversus Abdominis Plane Block for Pain Management After Hepatectomy for Hepatocellular Carcinoma: A Prospective Controlled Study

Xiao-Fei Qiao123BDEF, Wei-Dong Jia123DG, Yue-Qing Li1B, Jian-Guo Lv123D, Hong Zhou123AC*

DOI: 10.12659/MSM.912843

Med Sci Monit 2019; 25:1053-1060

Abstract

BACKGROUND: This study aimed to investigate the effectiveness of perioperative parecoxib sodium combined with transversus abdominis plane (TAP) block on postoperative pain management following hepatectomy in patients with hepatocellular carcinoma (HCC).

MATERIAL AND METHODS: One hundred patients with HCC who underwent hepatectomy were randomized into a study group (n=51) and a control group (n=49). The study group received 40 mg of parecoxib sodium 30 minutes before anesthetic induction, and 150 mg of 0.375% ropivacaine with 5 mg dexamethasone as TAP inhibitors, before closing the abdominal incision. The control group received 40 mg of placebo 30 minutes before anesthetic induction, without TAP block. Postoperatively, all patients received patient-controlled intravenous analgesia (PCIA) and evaluation with subjective visual analog scale (VAS) pain scores. Data on adverse events, postoperative ambulation (>6 hours/day), time of flatus and defecation, and hospitalization duration were recorded.

RESULTS: Pain scores of the study group were significantly lower compared with the control group on the first three postoperative days. No significant differences were found between the two groups in terms of adverse events. In the study group, the number of cases of postoperative ambulation was significantly more than the control group. The onset of flatus and defecation and duration of hospital stay in the study group were significantly shorter in the study group compared with the control group.

CONCLUSIONS: Parecoxib sodium combined with TAP block effectively reduced postoperative pain, improved ambulation, improved gastrointestinal function, and shortened hospitalization time following hepatectomy in patients with HCC without adverse effects.

Keywords: Analgesia, Carcinoma, Hepatocellular, Hepatectomy, Abdominal Muscles, Analgesia, Patient-Controlled, Analgesics, Opioid, Anesthetics, Local, Isoxazoles, Liver Neoplasms, Nerve Block, pain management, Pain Measurement, Pain, Postoperative, Postoperative Complications, Prospective Studies, ropivacaine

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750