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Effect of COX-2 Selective Inhibitors on Postoperative Insulin Resistance After Gastrointestinal Laparoscopic Surgery

Phase 4
Conditions
Gastrointestinal Cancer
Interventions
Registration Number
NCT01930318
Lead Sponsor
Jinling Hospital, China
Brief Summary

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.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
164
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PCA,parecoxib,placeboparecoxibPCA 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,celecoxibparecoxibPCA 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
Primary Outcome Measures
NameTimeMethod
Insulin resistance in perioperative period of gastrointestinal laparoscopic surgery5 days after operation
Secondary Outcome Measures
NameTimeMethod
Pain intensity at rest and during leg raising recorded daily after surgery using Visible Numeric Rating Scale5 days after operation
Incidence of adverse events throughout the treatment period including nausea, vomiting, headache, urinary retention, somnolence, flatulence, and pruritus5 days after operation or more
Liver and renal function tests in perioperative period5 days after operation
Self-rating anxiety scale and self-rating questionnaire for depression before surgery1 day before surgery
The consumption of total and incremental tramadol after surgery.5 days after operation
The tolerated dose of enteral nutrition every day after surgery5 days after operation
Postoperative inflammatory factors (IL-4, IL-6 and TNF-α) and levels of stress hormone (glucocorticoids and catecholamines) in perioperative period of gastrointestinal laparoscopic surgery5 days after operation
Rest energy metabolism was measured in perioperative period to evaluate the caloric and substrate needs of our patients5 days after operation
The time of the first bowel movements and anal exhaust time after surgery5 days after operation or more

Trial Locations

Locations (1)

Jinling Hospital

🇨🇳

Nanjing, Jiangsu, China

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