To evaluate the safety and efficacy of parecoxib combined with ropivacaine in early analgesia after laparoscopic cholecystectomy (LC).

In this prospective study, 100 patients with benign gallbladder diseases underwent LC in Lingnan Hospital, the Third Affiliated Hospital ofSun Yat-sen University from July 2020 to June 2021 were recruited. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 44 patients were male and 56 female, aged from 24 to 77 years, with a median age of 43 years. All patients were divided into the study group (n=50) and control group (n=50) according to the random number table method. Patients in the study group were given intravenous injection of 40 mg parecoxib at 10 min before surgery, and subcutaneous infiltration anesthesia of ropivacaine was delivered before suturing. In the control group, an equivalent quantity of normal saline was delivered. The visual analogue scale (VAS) score of postoperative pain and use of analgesics were recorded. The perioperative conditions and complications was observed.

In the study group, the static VAS scores at postoperative 1, 6 and 12 h were 2.0±0.7, 2.2±0.4 and 1.1±0.2, significantly lower than 3.7±0.4, 3.6±0.4 and 2.2±0.3 in the control group (t=-2.192, -2.257, -2.811; P<0.05). At l, 6, 12 and 24 h after operation, the dynamic VAS scores in the study group were 2.7±0.6, 3.1±0.2, 2.1±0.4 and 1.3±0.1, significantly lower than 4.4±0.4, 4.7±0.4, 3.2±0.3 and 2.5±0.2 in the control group (t=-2.427, -3.424, -2.454, -4.417; P<0.05). The first off-bed activity time in the study group was (8.5±0.5) h, significantly earlier than (10.5±0.7) h in the control group (t=-2.307, P<0.05). In the study group, the length of hospital stay was (5.3±0.3) d, significantly shorter than (7.3±0.8) d in the control group (t=-2.292, P<0.05). In the study group, analgesics were used in 4 cases after operation, significantly less than 13 cases in the control group ( χ²=5.740, P<0.05). No postoperative wound infection, abdominal infection, abdominal hemorrhage, respiratory depression and other complications occurred in both groups. At postoperative 12 h, WBC, C-reactive protein and IL-6 in the study group were (10.0±1.1)×10⁹/L, (37.4±7.2) mg/L and (56.4±8.7)ng/L, significantly lower than (14.2±1.5)×10⁹/L, (65.1±6.9) mg/L and (80.9±6.1) ng/L in the control group (t=-2.163, -2.778, -2.314; P<0.05).

Parecoxib combined with ropivacaine is a simple, safe and effective analgesia approach after LC, which can yield high efficacy, mitigate stress reaction and accelerate postoperative recovery.