Effects of Parecoxib on postoperative liver function in Patients Undergoing hepatectomy of hepatic carcinoma

Liver resection may require hepatic inflow occlusion to diminish intraoperative blood loss,thus may result in transient ischemia followed by reperfusion(I/R),which may initiate liver injury and lead to postoperative liver dysfunction. Nonsteroidal anti-inflammatory drugs (NSAIDs) may prevent or reduce hyperalgesia, inhibit inflammation, and reduce pain by reducing the synthesis of prostaglandins in response to tissue damage caused by surgery. There are some hepatic side effects reported by several spontaneous reports. While evidence from animal studies has shown that administration of COX-2 inhibitors minimize hepatic necrosis in chloroform induced liver injury. The aim of this study is to compare the effects of parecoxib, flurbiprofen and placebo in patients undergoing hepatectomy of hepatic carcinoma. Since Pringle’s maneuver are commonly applied by most of surgeons in our center which also cause an inevitable liver damage perioperatively, therefore providing us an ideal clinic model of hepatic I/R injury. The pain under mobilization registered via a visual analogue score. The injury of hepatocytes is evaluated by measuring plasma levels of alanine transaminase (ALT),aspartate aminotransferase(AST),interleukin 1 (IL-1), and tumor necrosis factor alpha (TNFa) levels. postoperative recovery is evaluated by hospital stay and complications. Liver resection may require hepatic inflow occlusion to diminish intraoperative blood loss,thus may result in transient ischemia followed by reperfusion(I/R),which may initiate liver injury and lead to postoperative liver dysfunction.