Effect of parecoxib combined with ropivacaine for incision infiltration on agitation during recovery from anesthesia in patients undergoing abdominal hepatectomy

Objective To evaluate the effect of parecoxib combined with ropivacaine for incision infiltration on agitation during recovery from anesthesia in patients undergoing abdominal hepatectomy. Methods Forty patients of both sexes, aged 35-64 yr, with body mass index of 18-24 kg/m2, of American Society of Anesthesiologists physical statusⅠ or Ⅱ, undergoing elective partial hepatectomy, were divided into parecoxib sodium group (group P) and parecoxib sodium plus ropivacaine group (group RP) with 20 cases in each group. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation in group P. Parecoxib sodium 40 mg was intravenously injected at 30 min before operation, and incision infiltration was performed with 0.5% ropivacaine 20 ml at the end of surgery in group RP.Patient-controlled intravenous analgesia was performed at the end of surgery in both groups.The development of agitation, respiratory depression and nausea and vomiting was recorded within 30 min after operation.Blood samples were collected from the radial artery immediately before induction (T0), at the end of surgery (T1) and at removal of extubation (T2) for determination of plasma cortisone (Cor) concentrations (by radio-immunity method), plasma epinephrine (E) and norepinephrine (NE) concentrations (by enzyme-linked immunosorbent assay) and blood glucose (using a blood gas analyzer). Results Compared with the baseline at T0, the plasma concentrations of Cor, Glu, E and NE were significantly increased at T1, 2 in two groups (P>0.05). The incidence of agitation and plasma concentrations of Cor, Glu, E and NE were significantly lower at T1, 2 in group RP than in group P (P<0.05). No patients developed nausea and vomiting and respiratory depression in two groups. Conclusion Parecoxib combined with ropivacaine for incision infiltration can decrease the occurrence of agitation during recovery from anesthesia, which is related to inhibiting stress responses of patients undergoing abdominal hepatectomy. Key words: Cyclooxygenase 2 inhibitors; Amides; Anesthesia recovery period; Dysphoria