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| Name | Class |
|---|---|
| National Natural Science Foundation of China | OTHER_GOV |
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It is well established that the resistance to the effects of insulin on glucose metabolism develops with a lot of stress hormone release after surgical trauma. This condition is known as insulin resistance (IR) characterized by hyperglycemia, hyperinsulinemia and lactic acidosis. Surgical IR not only affect glucose metabolism but also influence protein synthesis, then further exacerbate the depletion of the carbohydrate, fat and protein.
Postoperative pain is a challenging task for patients and surgeons, and it is part of the stress response to trauma and surgery, while the fear of pain can exacerbate the stress response.
The main aim of this study was to invest whether effective postoperative analgesia can reduce the stress response and insulin resistance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PCA,Placebo,Placebo | Placebo Comparator | PCA for 2 days after operation, i.v placebo in 2 days after surgery and oral placebo in the day 3 to day 5 after surgery | |
| PCA,placebo,tramadol | Placebo Comparator | PCA for 2 days after operation, i.v placebo in 2 days after surgery, and oral tramadol in the day 3 to day 5 after surgery | |
| PCA,parecoxib,placebo | Experimental | PCA for 2 days after operation, i.v parecoxib in 2 days after surgery,and oral placebo in the day 3 to day 5 after surgery |
|
| PCA,parecoxib,celecoxib | Experimental | PCA for 2 days after operation,i.v parecoxib in 2 days after surgery and oral celecoxib in the day 3 to day 5 after surgery |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| parecoxib | Drug | 4 groups: PCA,Placebo,Placebo-PCA for 2 days after operation, i.v placebo in 2 days after surgery and oral placebo in the day 3 to day 5 after surgery; PCA,placebo,tramadol-PCA for 2 days after operation, i.v placebo in 2 days after surgery, and oral tramadol(0.1g t.i.d.) in the day 3 to day 5 after surgery;PCA,parecoxib,placebo-PCA for 2 days after operation, i.v parecoxib(40mg b.i.d.) in 2 days after surgery,and oral placebo in the day 3 to day 5 after surgery;PCA,parecoxib,celecoxib-PCA for 2 days after operation,i.v parecoxib(40mg b.i.d.) in 2 days after surgery and oral celecoxib(0.2g b.i.d.) in the day 3 to day 5 after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Insulin resistance in perioperative period of gastrointestinal laparoscopic surgery | 5 days after operation |
| Measure | Description | Time Frame |
|---|---|---|
| The consumption of total and incremental tramadol after surgery. | 5 days after operation | |
| The tolerated dose of enteral nutrition every day after surgery | 5 days after operation | |
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Inclusion criteria:
Exclusion criteria：
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Wengcheng Kong, MD | Contact | 15850722032 | wenchengkong@gmail.com | |
| Yousheng Li | Contact | 8602580860137 | liys@medmail.com.cn |
| Name | Affiliation | Role |
|---|---|---|
| Wencheng Kong, MD | Nanjing University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Jinling Hospital | Recruiting | Nanjing | Jiangsu | 200002 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23328338 | Background | Xu Z, Li Y, Wang J, Li J. Effect of postoperative analgesia on energy metabolism and role of cyclooxygenase-2 inhibitors for postoperative pain management after abdominal surgery in adults. Clin J Pain. 2013 Jul;29(7):570-6. doi: 10.1097/AJP.0b013e318270f97b. |
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| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| C409945 | parecoxib |
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| Postoperative inflammatory factors (IL-4, IL-6 and TNF-α) and levels of stress hormone (glucocorticoids and catecholamines) in perioperative period of gastrointestinal laparoscopic surgery |
| 5 days after operation |
| Rest energy metabolism was measured in perioperative period to evaluate the caloric and substrate needs of our patients | 5 days after operation |
| The time of the first bowel movements and anal exhaust time after surgery | 5 days after operation or more |
| Pain intensity at rest and during leg raising recorded daily after surgery using Visible Numeric Rating Scale | 5 days after operation |
| Incidence of adverse events throughout the treatment period including nausea, vomiting, headache, urinary retention, somnolence, flatulence, and pruritus | 5 days after operation or more |
| Liver and renal function tests in perioperative period | 5 days after operation |
| Self-rating anxiety scale and self-rating questionnaire for depression before surgery | 1 day before surgery |
| D005767 |
| Gastrointestinal Diseases |