Parecoxib Sodium

To study the effect of parecoxib sodium in alleviating inflammation in burned rats and restoring cognitive function in burned rats. A total of 30 specific pathogen free grade Sprague–Dawley rats were randomly divided into 6 groups: (1) blank control group (group C), (2) Sham surgery group (group Sham), (3) second-degree burn model (group B), (4) low-dose (1 mg/kg/d) parecoxib sodium (group L + B), (5) medium-dose (10 mg/kg/d) parecoxib sodium (group M + B), and (6) high-dose (20 mg/kg/d) parecoxib sodium (group H + B). ELISA measures inflammatory factors interleukin (IL)-2, IL-6, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ), and cognitive function factors neuron-specific enolase (NSE), cortisol, and S-100β. Combined with water maze and dark-avoidance experiments to further verify the recovery of cognitive function in rats. The contents of IL-2, TNF-α, and IL-6 in group M + B were significantly lower than those in group Sham (P < .05), and the content of IFN-γ was significantly lower than that in group Sham (P < .05). The cognitive markers NSE, S-100β, and cortisol levels in group M + B were significantly higher than those in group Sham at 2 h, 1 d, 5 d, and 10 d after operation (P < .05). In the group M + B dark-avoidance experiment, the number of probes and errors was not significantly different than those in group Sham and group C (P > .05), and the number of times group M + B found a platform in the water maze experiment and crossed the platform was second only to group B and group C. Parecoxib sodium can effectively reduce inflammation in burn rats and promote cognitive recovery in burn rats, and the optimal dose of parecoxib sodium for burn rats is 10 mg/kg.

Cisplatin is commonly prescribed in hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal malignancy. Acute kidney injury (AKI) is regarded as a common complication after HIPEC combined with cytoreductive surgery (CRS). However, post-HIPEC chronic kidney disease (CKD) is scarce and less investigated. This study aims to investigate the incidence of CKD following cisplatin-based HIPEC and to analyse the associated risk factors.

From January 2016 to August 2021, a total of 55 patients treated with CRS and cisplatin-based HIPEC for peritoneal carcinomatosis were categorized retrospectively into groups, with and without CKD. Demographics, comorbidity, surgery, postoperative management, and complications were collected to evaluate risk factors for cisplatin-based HIPEC-related CKD. Univariate and multivariate analyses were conducted to confirm the correlation between different variables and CKD occurrence.

Of the 55 patients, 24 (43.6%) patients developed AKI and 17 (70.8%) patients of these AKI patients progressed to CKD. Multivariate regression analysis identified intraoperative use of parecoxib (Odds Ratio (OR) = 4.39) and intraoperative maximum temperature > 38.5°C (OR = 6.40) as major risk factors for cisplatin-based HIPEC-related CKD occurrence. Though type II diabetes mellitus and intraoperative complications were the independent risk factors of AKI following cisplatin-based HIPEC, but they were not shown in CKD analysis.

Intraoperative use of parecoxib during cisplatin-based HIPEC emerged as a significant risk factor for postoperative CKD. Clinicians should exercise caution in prescribing parecoxib during HIPEC procedures. Additionally, maintaining intraoperative body temperature below 38.5°C might be crucial to mitigate the risk of CKD development. This study underscores the importance of identifying and preventing specific risk factors to improve long-term renal outcomes in patients undergoing cisplatin-based HIPEC.