Abstract: AIM: To determine the effect of preemptive analgesia with parecoxib sodium on balance of Th1/Th2 during radical resection of gastric carcinoma. METHODS: Fourty patients scheduled for radical resection of gastric carcinoma under general anesthesia were randomly allocated into groupⅠand groupⅡwith 20 cases each. Parecoxib sodium 40 mg was intravenously administered 30 minutes before anesthesia induction in groupⅠ, while in groupⅡ normal saline 5 mL was injected via vein route 30 minutes before anesthesia induction. All patients received intravenous injection of parecoxib sodium 40 mg 10 min before the end of operation and then were attached to a PCIA pump. PCIA with fentanyl 10 μg/kg was added into normal saline 100 mL in two groups. The infusion rate was 2 mL/h, bolus dose was 0.5 mL,lockout interval was 15 min. The plasma concentrations of cortisol, interferon-γ(INF-γ) and interleukin-4(IL-4) were measured before induction of anesthesia(T₁), at the end of operation(T₂), at 24h(T₃) and 72 h(T₄)after operation. RESULTS: Compared with T₁,Cor was higher at T₂ and T₃ in groupⅡand at T₃ in groupⅠ(P＜0.05). Cor levels at T₂ and T₃ were lower in groupⅠthan those in groupⅡ(P＜0.05).IL-4 of groupⅠwas lower at T₃ than that at T₁ (P＜0.05). IL-4 at T₄ was lower in groupⅠthan that in groupⅡ(P＜0.05). INF-γof groupⅠwas higher at T₂,T₃ and T₄ than those at T₁ (P＜0.05), which was higher at T₂ and T₃ than those of groupⅡ(P＜0.05).The ratio of IFN-γ/IL-4 in both groups was significantly higher at T₂,T₃ and T₄ than those at T₁, which at T₃ was higher in groupⅠ than that in groupⅡ(P＜0.05). CONCLUSION: Preemptive analgesia with parecoxib sodium can alleviate the excursion degree of Th1/Th2 and improve immunological suppression after radical resection of gastric carcinoma.

Key words: Parecoxib sodium, Preemptive analgesia, Interferon-γ, Interleukin-4