Abstract: Objective To analyze the effect of parecoxib pretreatment on inflammatory cytokines and hemodynamics in patients undergoing craniotomy. Methods A total of 84 patients undergoing selective craniotomy in our hospital from January 2018 to January 2019 were enrolled in the control group and the observation group according to different preoperative pretreatment methods, with 42 cases in each group. Patients were treated with 5 mL saline in the control group and 5 mL parecoxib in the observation group. Inflammatory cytokines (serum central nerve specific protein, neuron specific enolase, neuron specific enolase) were compared between the two groups. Interleukin 6, tumor necrosis factor-alpha, superoxide dismutase, hemodynamics (mean arterial pressure, heart rate), postoperative pain (VAS score) and postoperative complications (hypertension, chills, arrhythmia, restlessness). Results The levels of inflammatory cytokines in both groups were significantly different from those before operation, and the levels of serum central nervous specific protein, neuron specific enolase, interleukin-6 and tumor necrosis factor-alpha in the observation group were lower than those in the control group, while the levels of superoxide dismutase were higher than those in the control group, all P<0.05. The mean arterial pressure and heart rate of the observation group at 1 and 6 hours after operation were lower than those of the control group (all P<0.05); the mean arterial pressure and heart rate of the two groups at 1 and 6 hours after operation were lower than those before operation (all P<0.05). The VAS scores of the observation group at 1, 6, 12 and 24 hours after operation were lower than those of the control group (all P<0.05); the VAS scores of the observation group at 6, 12 and 24 hours after operation were higher than those of the one hour after operation (all P<0.05). The incidence of postoperative complications in the observation group (14.3%) was lower than that in the control group (35.7%), P<0.05. Conclusion Pretreatment with parecoxib has a positive effect on patients undergoing craniotomy. It can reduce the influence of operation on serum inflammatory cytokines. The hemodynamics of patients is stable. The pain is mild and the incidence of complications is low. It is worth clinical application.