Abstract

ABSTRACT :
Introduction: Inflammation and postoperative pain plays an important role in the etiopathogenesis of postoperative cognitive dysfunction (POCD). COX-2 inhibitor celecoxib is frequently used for treatment of acute pain due to its potent anti-inflammatory and analgesic effects. Herein, we evaluated the effects of celecoxib on POCD and postoperative pain in elderly patients.
Material and method: We enrolled 84 patients of either sex, age more than 65year, ASA grade I to III who were planned for hip( fracture neck femur )surgery. They were randomly divided into two groups and treated with either celecoxib (group A) or placebo (group B) for one week starting from one day before surgery. Mini-Mental State Examination (MMSE) was done at one day before surgery and at day seven after surgery. POCD was diagnosed if MMSE score below 24(out of 30). Numerical rating scale (NRS) was used to measure pain intensity one day before surgery and at postoperative day three and seven.
Results: MMSE at day1 and postoperative day 7 was 25.74±1.45 ,24.88±1.35 and in group A ; 26.45±1.56 ,23.64±2.13. in group B . NRS scores at postoperative day 1,3 and 7 was 3.26±1.43, 3.38±0.66, 1.19±0.71 in group A and 3.62±0.82, 2.93±0.681,31±0.72,in group B.
Conclusion: We concluded that celecoxib decreases early postoperative cognitive dysfunction incidence in elderly patients of femur neck fracture.

Key words: POSTOPERATIVE COGNITIVE DYSFUNCTION, CELECOXIB,NUMERIC RATING SCALE,ELDERLY,Mini-Mental State Examination.