[Effects of parecoxib sodium preemptive analgesia on perioperative cytokine responses and stress responses in patients undergoing ophthalmology surgery].
OBJECTIVE
To investigate the effects of parecoxib sodium preemptive analgesia on perioperative cytokine responses and stress responses and postoperative analgesia in patients undergoing ophthalmology surgery.


METHODS
One hundred ASAI-II patients undergoing ophthalmology surgery were randomly divided into 2 groups of fifty: the parecoxib group received parecoxib 40 mg by muscle injection, the control group received an equal volume of 0.9% normal saline two ml. Venous blood samples were obtained at 10 minutes before parecoxib or 0.9% normal saline was injected (T1), 30 minutes (T2) and 60 minutes (T3) after surgery was initiated, the moment when surgery was finished (T4), 6 hours (T5), 12 hours (T6) and 24 hours (T7) after surgery was finished for determination of the plasma levels of IL-6, IL-8, IL-1RA, TNF and IL-1β. At the same time, the plasma levels of epinephrine, norepinephrine, cortisol and adrenocorticotropic hormone at T1-T6 were measured. VAS scores with patients were recorded at 1, 2, 6, 12, 24 h after surgery.


RESULTS
The change of the plasma levels of IL-6, IL-8, IL-1RA, TNF, IL-1β in the two groups:in the parecoxib group the plasma levels of TNF and IL-1β did not decreased significantly as compared with the control group (P > 0.05). The plasma levels of IL-6, IL-8 at T4-T6 decreased significantly as compared with the control group (P < 0.01). The plasma levels of IL-1RA at T3-T6 decreased significantly as compared with the control group (P < 0.01). The change of the plasma levels of epinephrine, norepinephrine, cortisol and adrenocorticotropic hormone in the two groups:in the parecoxib group the plasma levels of epinephrine, norepinephrine at T2, T3 decreased significantly as compared with the control group (P < 0.01). In the parecoxib group the plasma levels of cortisol at T2-T4 decreased significantly as compared with the control group (P < 0.01). In the parecoxib group the plasma levels of adrenocorticotropic hormone at T2-T5 decreased significantly as compared with the control group (P < 0.01). Postoperation VAS scores:VAS scores of the parecoxib group were less than that of the control group (P < 0.05).


CONCLUSIONS
Preoperatively-administered parecoxib during ophthalmology surgery can produce better analgesia effect, reduce the production of cytokines, decrease central nervous system sensitization so as to improve the quality of postoperative pain relief. At the same time, it can reduce perioperative stress hormone release so as to have a positive effect on post operative recovery.
Xu
Li-li
LL
Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China.
Shen
Jian-jun
JJ
Zhou
Hai-yan
HY
D000293:Adolescent; D000328:Adult; D000698:Analgesia / Q000379:methods*; D005260:Female; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007432:Intraoperative Period; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011292:Premedication; D055815:Young Adult
D006728:Hormones; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D016209:Interleukin-8; D007555:Isoxazoles; C409945:parecoxib