Objective To investigate the effects of preoperative parecoxib on the levels of inter-leukin 6 (IL-6)and postoperative analgesia for breast surgery.Methods Sixty breast cancer patients undergoing mastectomy were randomly divided into two groups:parecoxib group (group P)and con-trol group (group C),n=30 in each group.All patients received sevoflurane and fentanyl anesthesia. Group P was injected parecoxib 40 mg at 10 minutes before induction of anesthesia,meanwhile group C was injected saline 5 ml.All patients received postoperative patient-controlled intravenous analgesia (PCIA)with fentanyl.VAS scores for pain were assessed at postoperative 2,4,8,12,24 hours. The serum levels of IL-6 were measured by ELISA at 10 minutes before induction,4 h,8 h,and 24 h after surgery.Results Group P had lower VAS scores than group C at 2-12 h after surgery (P <0.05).Compared with 10 minutes before induction,the levels of IL-6 increased significantly at post-operative 4,8,24 h in two groups (P<0.01),while group P had lower levels of IL-6 than group C (P <0.01).Conclusion Preoperative administration of parecoxib has a stronger analgesic effect in breast cancer patients after mastectomy,and decreases the levels of IL-6.

Objective To observe the effect of intraoperative continuous pump infusion of remima-zolam on postoperative delirium(POD)in elderly patients with hip fracture under subarachnoid block.Methods A total of 236 elderly patients undergoing elective hip fracture surgery under subarachnoid block,82 males and 154 females,aged≥65 years,BMI 18.5-31.0 kg/m2,ASA physical status Ⅰ-Ⅲ,were divided into two groups by using the randomized number table method:remimazolam group(group R)and control group(group C),118 patients in each group.When the surgical site was disinfected and cov-ered,the patients in group R were administered the first dose of reminmazolam 0.1 mg/kg and followed by a continuous infusion 0.2 mg·kg-1·h-1 intravenously to maintain the modified observer's assessment of alert/sedation(MOAA/S)1 or 2 scores.Reminmazolam infusion was stopped at the end of the surgery.The same volume of normal saline was injected for patients in group C.POD was assessed by the confusion as-sessment method-Chinese revised version(CAM-CR)1-3 days after the surgery.The anxiety scores one day before and one day after the surgery,and plasma cortisol concentrations when the patients were admitted into the operating room and at the end of the surgery were recorded.The incidence of intraoperative hypertension,hypotension,bradycardia,hypoxemia,and postoperative nausea and vomiting were also recor-ded.Results Compared with group C,POD incidence in group R was significantly decreased(P＜0.05),anxiety score one day after surgery and plasma cortisol concentration at the end of the surgery in group R were significantly decreased(P＜0.05),and the incidence of intraoperative hypertension in group R was significantly decreased(P＜0.05).There were no significant differences in the plasma cortisol con-centrations when the patients were admitted into the operating room and the incidences of intraoperative hy-potension,bradycardia,hypoxemia,and postoperative nausea and vomiting between the two groups.Conclusion Remimazolam can reduce the incidence of postoperative delirium in elderlypatients undergoing hip fracture surgery under subarachnoid block,which may be related to alleviating intraoperative anxiety and inhibiting intraoperative stress response.