The Effect Of Pre-operative Parecoxib Injected On Postoperative Pain After Laparoscopic Cholecystectomy Of Total Intravenous Anesthesia

Object: To determine The effect of pre-operative parecoxib injected as preemptive analgesia on postoperative pain after laparoscopic cholecystectomy of total intravenous anesthesia.Methods: A prospective,double-blind,randomized,placebo-controlled study was conducted on 60 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at the Third Hospital of Hebei Medical University, Shijiazhuang, from September 2009 to December 2009. Patients were randomly divided into three groups(n=20), control group (groupA), preemptive analgesia treatment group (group B), normal analgesia treatment group (group C). Patients were randomized to receive eigher normal saline infusion 30 min before induction of anesthesia and 40 mg parecoxib infusion at the time of suturing skin(group C),40 mg parecoxib infusion 30 min before induction of anesthesia and normal saline infusion at the time of suturing skin(group B), or normal saline infusion 30 min before induction of anesthesia and normal saline infusion at the time of suturing skin as a placebo(group A).The degree of the postoperative pain was assessed in the first 24 h after surgery using visual analog scales(VAS). Fentanil 50μg was injected when the degree of pain exceed 4scale in VAS. The consumption of analgesics ,and the condition of side effect was recorded. Venous blood samples were collected before experiment and at suturing skin, 24h after surgery. Concentrations of substance P in plasma and interleukin 6 in plasma were measuredwith Elisa method.Results:1. No significant differences were found in age,body mass index and operation duration among the three groups, P >0.05.2. The pain scores at each time point statistically insignificant differed among the three groups, P >0.05 .3. Analgesic consumption was significant difference among the three groups. Compared with group A and group C,Analgesic consumption in group B was obviously reduced(P <0.05).4. The concentrations of interleukin 6 in three groups were similar and statistically insignificant before surgery(P﹥0.05).The concentrations of interleukin 6 in three groups were similar and statistically insignificant before surgery(P﹥0.05).Plasma interleukin 6 concentrations in three groups during and after operation were significantly higher than those before surgery. there was significant difference of plasma interleukin 6 in three groups during operation and 24h after surgery.5. The concentrations of substance P in three groups were similar and statistically insignificant before surgery(P﹥0.05).Plasma substance P concentrations in three groups during and after operation were significantly higher than those before surgery. there was insignificant difference of plasma substance P in three groups during operation and 24h after surgery.Conclusion:1. Pre-operative infusion 40 mg parecoxib could significantly reduce the postoperative opioid consumption .2. Pre-operative infusion 40 mg parecoxib could significantly inhibit the production of interleukin 6 in plasma.3. Pre-operative infusion 40 mg parecoxib could not be proved to inhibite the production of substance P in plasma.