Effect of parecoxib in the treatment of postoperative cognitive dysfunction

Abstract

Background:Parecoxib is a selective cyclooxygenase (COX)-2 inhibitor widely used as an analgesia technique in perioperative period for its potent anti-inflammatory and analgesic effects. However, litter is known about its effect on postoperative cognitive dysfunction (POCD). The purpose of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the effect of parecoxib in the treatment of postoperative cognitive dysfunction.Methods:We searched PubMed, Cochrane Library and Embase databases for relevant studies up to October 2017. We selected fixed-effect model for analysis of data heterogeneity. Statistical analyses were performed by using Review Manager Version 5.3 for Windows.Results:Four RCTs with 904 patients that underwent surgical operations were included. The meta-analysis demonstrated parecoxib could significantly decrease the incidence of POCD on postoperative day 1, day 3, day 5, and day 7 when compared with control treatment; IL-6 and S100β concentrations were lower up to postoperative day 2. The consumption of morphine, fentanyl and tramadol in parecoxib groups were lower than control groups.Conclusion:Our meta-analysis suggested that the administration of Parecoxib was effective in treating early POCD within 7 days and reducing IL-6 and S100β concentrations within 2 days after operations. Nevertheless, our current study with some limitations such as the small sample size only provided limited quality of evidence, confirmation from further meta-analysis with large-scale, well-designed RCTs is required.

Ginkgolide B‑mediated therapeutic effects on perioperative neurocognitive dysfunction are associated with the inhibition of iNOS‑mediated production of NO

“…Perioperative neurocognitive disorder (PND) is a common cognitive complication of surgery, especially among older patients, which is characterized by progressive cognitive deterioration in the preoperative or postoperative period. PND has several clinical manifestations, including attention deficits, learning disabilities and memory loss (1,2). In the long term, PND can result in prolonged hospitalization, decreased quality of life and increased financial burden on the family and society (3).…”

Lithium chloride ameliorates cognition dysfunction induced by sevoflurane anesthesia in rats

“…POCD can prolong hospital course, hinder disease recovery, raise postoperative complications and lower the quality of life after discharge . Yet, the current approaches to prevention and treatment for POCD are quite rare, and the treatment effect is still unsatisfactory . Therefore, it is important to find more effective approaches to treat POCD.…”

Effect of propofol‐based total intravenous anaesthesia on postoperative cognitive function and sleep quality in elderly patients

“…In clinical practice, S-100β protein and IL-6 can be used as biological and chemical markers of postoperative cognitive dysfunction to evaluate brain injury. 24,25 The S-100 protein family belongs to a group of acidic proteins that can connect with calcium and affect various cellular responses in the calcium signalling transduction pathway. 26 S-100β is an important member of the S-100 family.…”

“…24 A plenty of studies found that S-100β protein and IL-6 levels are positively associated with POCD. 24,25 Melatonin (N-acetyl-5-methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night. 29 Cortisol is one of the major glucocorticoid hormones secreted by the adrenal cortex.…”

“…Factors such as surgery and anaesthesia can lead to an increase in serum IL‐6 level and promote inflammation in the body 24 . A plenty of studies found that S‐100β protein and IL‐6 levels are positively associated with POCD 24,25 . Melatonin (N‐acetyl‐5‐methoxytryptamine) is an endogenous hormone produced by the pineal gland and released exclusively at night 29 .…”