Preemptive analgesic effects of parecoxib on postoperative analgesic efficacy and serum cytokine response in patients undergoing gastrointestinal tumor resection

Objective To observe the preemptive analgesic effects of parecoxib on postoperative analgesic efficacy and serum cytokine in patients after gastrointestinal tumor surgery.Methods Sixty ASA Ⅰ or Ⅱ patients undergoing gastrointestinal tumor surgery were randomly allocated into 2 groups (n=30 each): Parecoxib sodium combined with fentanyl group (group P), and fentanyl group (group F). At 30 minutes before skin incision and 12 hours after surgery, group P received intravenous infusion of 40 mg parecoxib sodium separately,Group F received intravenous infusion normal saline 2 ml at these time points. Patients received an patient controlled analgesia (PCA) regimen of Fentanyl after surgery. VAS score were recorded at 2, 6, 12 and 24 hours after surgery. Total fentanyl consumption was recorded at 12 and 24 h after surgery. The concentration of serum interleukin-6(IL-6), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-a) were assessed before surgery, at the end of surgery, 6 h after surgery, 24 h after surgery. Adverse effects were also recorded.Results VAS scores at 2,6,12 and 24 h after operation were lower in group P(P0.05) compared with group F. The fentanyl consumption recorded at 12 and 24 h after surgery was lower in group P(P0.05). The concentration of serum IL-6 was lower in group P, but serum IL-10 was higer in group P versus group F(P0.05). There were no serious adverse effects in both groups.Conclusion Parecoxib sodium combined with fentanyl after gastrointestinal tumor surgery can provide better postoperative analgesia, reduce the fentanyl consumption, attenuated IL-6 production and increase IL-10 production.