Effect Of Cyclooxygenase-2Inhibitor Parecoxib On Lower Extremity Ischemia Reperfusion Injury

Objective:To assess the effect of selective Cyclooxygenase-2inhibitor Parecoxib on serum change in malondialdehyde(MDA), tumor necrosis factor-a(TNF-a), nitrogen monoxide(NO),interleukin-8(IL-8), Creatine Kinase(CK) and lactate dehydrogenase (LDH) after ischemia-reperfusion of lower extremity; To seek the sensitive marker of lower extremity ischemia reperfusion injury.Methods:40ASA Ⅰ-Ⅱ scheduled for operation of lower extremity were randomly allocated to one of the two groups:Parecoxib group (group A, n=20)and control group(group B, n=20). Spinal anesthesia was performed in both groups:Group A was accepted intravenous injection with Parecoxib40mg(added to5ml saline)before anesthesia. Group B was intravenous injected the same volume of saline at the same time. The median cubital vein blood was drawn before tourniquet roped(T1), after tourniquet Loosen5minuter(T2),30minuter(T3)and120minuter(T4), then the serum concentrations of MDA,TNF-a,NO,IL-8,CK,LDH were measured. Results:Comparison of difference among within group:In group A, plasma CK concentrations was significantly increased at T2, T3and T4compared with T1(P<0.05),plasma MDA,TNF-a,IL-8concentrations was significantly increased at T3and T4compared with T1(P<0.05), plasma LDH concentrations was significantly increased at T3compared with T1(P<0.05);In group B,plasma MDA and CK concentrations were significantly increased at T2, T3and T4compared with T1(P<0.05),plasma TNF-a,IL-8concentrations were significantly increased at T3and T4compared with T1(P<0.05);There is no statistical difference among NO in group A and among NO,LDH in group B at any time (P>0.05). Comparison of difference between the two groups:There is no statistical difference among TNF-a,NO,IL-8,CK at any time between two groups(P>0.05); The MDA concentration of group A was significantl decreased than group B in T2(P<0.05);The LDH concentration of group A was significantl increased than group B in T3(P<0.05).Conclusions:Clinical dose of Parecoxib can not attenuate ischemia-reperfusion injury of lower extremity;MDA,TNF-a,IL-8and CK are preferable markers more sensitive to assess the level of postischemia-reperfusion injury than LDH and NO.