The Influence On Postoperative Analgesia, IL-12 And IL-4 Of Parecoxib In Laparoscopic Dixon Surgery

Objectives:This study was to determine whether parecoxib was efficacy and safety in patients undergoing laparoscopic Dixon surgery as postoperative analgesia and to discover the difference between preoperative and postoperative groups.Also to explore whether parecoxib had effect on inflammatory and immune function by observed on serum IL-12, IL-4 levels.Methods:30 patients were selected,ASAⅠ-Ⅱlevel, who were scheduled for laparoscopic Dixon surgery with general anesthesia. This was a randomized, controlled study.30 patients were divided into three groups:A group (preoperative group n=10), patients were intravenous injected 40mg parecoxib at induction and 12 hours after induction,also intravenous injected 2ml saline after skin closure. B group (postoperative group n=10), patients were intravenous injected 40mg parecoxib after skin closure and 12 hours after induction,also intravenous injected 2ml saline at induction. C group (control group n=10), patients were intravenous injected 2ml saline at all of the three time points.Recorded the visual analogue score (VAS) at 2,4,6,8,12,20,24 hours after surgery, recorded overall impression of pain treatment and consumption of tramadol in the fist 24 hours. Before anesthesia,2h,12h and 24h after the surgery, concentrations of plasma Interleukin-12 and Interleukin-4 were measured and analyzed. Recorded the side effect, hepatic and renal function.Results:The age, height, BMI, gender, operative time, anesthetic dosage, and access to water during groups had no significant difference (P>0.05).①VAS of control group was higher than pre, post groups(P<0.05).VAS of pre group was lower than post group,but there was no significant difference(P>0.05). The overall impression of pain treatment as well as less consumption of tramadol of Pre,Post groups was better than control group.②IL-12 level was descended at first,then recovered, control group was lower than Pre,Post groups(P<0.05),pre group was higher than post group, but the difference had no statistically significant (P>0.05).③IL-4 level was increased, control group was higher than Pre,Post groups(P<0.05), pre group was lower than post group, but the difference had no statistically significant (P>0.05).④the trend of IL-12/IL-4 ratio was like IL-12 level, Pre,Post groups was higher than control group at each time point (P< 0.05). Pre group was higher than Post group, but the difference had no statistically significant (P>0.05).⑤The side effect, had no significant difference during groups, hepatic and renal function was normal.Conclusion:1.Parecoxib 40mg twice daily, was efficacy and safety in patients undergoing laparoscopic Dixon surgery as postoperative analgesia. There was no significant difference between preoperative and postoperative groups.2.Parecoxib could increase IL-12 secretion and inhibit IL-4 increased, rising IL-12/IL-4 ratio either premedication or postmedication and induced THO to TH1 differentiation.It was beneficial for anti-infection immunity.