关键词: 环氧化酶-2, 抑制剂, 超前镇痛, 人工气腹, 肺功能

Abstract: AIM: To investigate the effect of parecoxib sodium premedication on pulmonary function in patients with rectal cancer undergoing laparoscopic eradication.METHODS: Sixty ASA Ⅱ or Ⅱpatients with rectal cancer, aged 48-67 year and weighing 52-68 kg undergoing laparoscopic eradication were randomly divided into 2 groups (n=30 each):control group(group C) and parecoxib sodium group(group P) . General anesthesia combined epidural blockade were performed in all eligible patients. Parecoxib sodium 40 mg (diluted to 5 mL with normal saline)was injected via vein route before anesthesia induction in group P, while in group C normal saline 5 mL was intravenously administered. Serum IL-6,IL-10 and TNF-α were assayed and arterial blood gas analysis were measured in the following time points: pre-induction(T₀),1 h after pneumoperitoneum(T₁),termination of pneumoperitoneum(T₂), postoperative 4 h(T₃)and 24 h(T₄). Respiratory index (RI) and PaO₂/FiO₂ were calculated.RESULTS: Compared with the baseline values at T₀, serum TNF-α and IL-6 concentrations at T_1-4 and serum IL-10 concentration at T_1-3 were significantly increased in group C, while in group P serum TNF-α and IL-6 concentrations at T_1-3 and serum IL-10 concentration at T_1-4 were significantly increased (P＜0.05). RI was significantly increased and PaO₂/FiO₂ was significantly descended at T_1-2 in two groups (P＜0.05). Serum TNF-α and IL-6 concentrations at T_1-4 and RI at T_1-2 were significantly lower while serum IL-10 concentration at T_1-4 and PaO₂/FiO₂ at T_1-2 were significantly higher in group P than those in group C (P＜0.05).CONCLUSION: Parecoxib sodium premedication can effectively protect the pulmonary function in patients with rectal cancer undergoing laparoscopic eradication by attenuating systemic inflammatory response .

Key words: Cycloxygenase-2 inhibitor, Preemptive analgesia, Artificial pneumoperitoneum, Pulmonary function  ,  ,  ,  ,