Effect of preemptive analgesia with parecoxib sodium on interleukin-6 and C-reactive protein level in patients undergoing radical excision of breast cancer

Abstract

Objective To investigate the preemptive analgesia of parecoxib sodium on interleukin-6 (IL-6) and C-reactive protein (CRP)level in patients undergoing radical excision of breast cancer,and to evaluate its analgesic effect.Methods Sixty ASA Ⅰ-Ⅱ patients undergoing radical excision of breast cancer were randomly divided into three groups(n=20):preemptive analgesia group(group A),blank control group(group B) and postoperative analgesia group(group C).Patients received intravenous parecoxib sodium 40 mg before 10 min(group A) or at the end of surgery(group C) or normal saline(group B).Blood samples were collected from all patients before anesthesia(T1) and at 1 h (T2),6 h (T3),24 h (T4) after surgery for assaying the plasma levels of interleukin-6 and C-reactive protein.Postoperative analgesic efficacy was assessed with visual analog scales (VAS).Results Compared with T1,the plasma levels of IL-6 and CRP were significantly higher at T2,T3 and T4 in all the three groups (P＜0.01).In group B,IL-6 and CRP levels were increased along with time progress,and were higher at T4 than at T2 (P＜0.01).The plasma levels of interleukin-6 in preemptive analgesia group at T2,T3,T4 time points were [(16.6±2.4),(27.0±3.7),(24.5 ±3.6) ng/L],lower than control group [(24.2±2.6),(32.9±4.2),(36.2±5.1) ng/L] and postoperative analgesia group [(20.8±2.7),(29.4±3.9),(31.9±4.4) ng/L] (P＜0.05).The plasma levels of C-reactive protein in preemptive analgesia group at T2,T3,T4 time points were [(10.6±2.4),(18.4±3.5),(40.7±4.3) mg/L],lower than control group [(14.9±3.2),(24.3±4.4),(54.6±5.4) mg/L] and postoperative analgesia group [12.3±2.6),(21.7±4.2),(45.6±4.8) mg/L] (P＜0.05).The VAS scores at both group A and C at 1,2,4,6 h,were [(2.1±1.0),(2.4±1.2),(2.9±1.3),(3.3±1.2)points],[(2.9±1.2),(3.2±1.2),(3.4±1.3),(3.6±1.2)points] lower than at the same time point of group B (P＜0.05).Pethidine consumption at 24 h after operation were higher in group B than in group A and group C (P＜0.05).The VAS scores were no significant differences at 12,24 h in three groups.Conclusions Preemptive analgesia with parecoxib can be achieved good analgesic effect and can effectively inhibit the postoperative of IL-6 and C-reactive protein level increased,regulate the body's inflammatory and stress response,possess immunization protection.,promote postoperative recovery. Key words: Parecoxib; Breast cancer; Preemptive analgesia; Interleukin-6; C-reactive protein