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Effect of parecoxib on postoperative anxiety and cognitive function after pancreaticoduodenectomy: A clinical trial

Zhang F, Ma L, Li X, Wang S, Di L

Medicine, 2026

80 participants

Abstract

Background: After pancreaticoduodenectomy, perioperative neurocognitive disorders (PND) are a common complication. Parecoxib, a selective cyclooxygenase-2 inhibitor, is used for its analgesic and antiinflammatory effects, but its impact on postoperative anxiety and cognitive function is not clear.

Methods: The patients undergoing laparoscopic pancreaticoduodenectomy at the Second Hospital of Hebei Medical University were enrolled in the study from November 1, 2020 to September 30, 2022 in this randomized controlled trial. Patients were randomly divided into Group P who received 20 mg of parecoxib intravenously 10 minutes before anesthesia and at the end of surgery and Group C who received an equal volume of normal saline at the same times. Primary outcomes included the effect of parecoxib on anxiety, cognitive impairment, and postoperative intestinal function recovery, with the incidence of PND calculated using the Z-value method. Secondary outcomes included pain control, length of hospital stay, postoperative recovery, complication rates, and analgesic use.

Results: 80 patients were enrolled and randomly divided into 2 groups of 40 equally: there were no significant differences in postoperative flatus passage, defecation time, hospital stay, or complication rates (P > .05). In terms of postoperative anxiety, the experimental group had significantly lower State Anxiety Inventory scores at 24 hours postoperatively (T2) (P < .05). Cognitive function, measured by Montreal…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 80 participants or records.

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