Effects of parecoxib on stress response in patients undergoing laparoscopic cholecystectomy during recovery period of general anesthesia

Objective To study the effects of parecoxib on the stress response during recovery period of general anesthesia with remifentanil. Methods Forty patients who were scheduled to undergo laparoscopic cholecystomy were randomly divided into parecoxib group (group P) and fentanyl group (group F); 20 patients in each growp. Anesthesia was equally maintained with propofol, remifentanil, cisatracurium and sevoflurane in all patients. Parecoxib sodium 40 mg was intravenously administered in group P when beginning to sew up the incision, while fentanyl 0.1 mg was intravenously administered in group F. MAP, HR and SpO2 were recorded at the following time points: 5 min before tracheal extubation, immediately after tracheal extubation, 5 min, 10 min and 15 min after tracheal extutation. Sedation-agitation scale (SAS) were recorded immediately after tracheal extubation. VAS was recorded at 15 min, 30 min,1 h and 2 h after tracheal extubation. Venous blood samples were collected 1 min after tracheal extubation for determination of the contents of epinephrine, norepinephrine, and cortisol. Tracheal extubation time and complications rate were recorded. Results MAP, HR, VAS, SAS, and tracheal extubation complications rate were lower in group P than that in group F (P<0.05). Tracheal extubation time was shorter in group P than in group F (P<0.05). The serum contents of epinephrine, norepinephrine, and cortisol were lower in group P than in group F (P<0.05). No difference was found in SpO2 between the two groups. Conclusion Intravenous administration of parecoxib can effectively inhibit the stress response in patients undergoing laparoscopic cholecystectomy during recovery period of general anesthesia with remifentanil. Key words: Parecoxib; Remifentanil; Anesthesia, general; Stress, physiological; Anesthesia recovery period