Abstract: Objective To investigate the effect of pretreatment with parecoxib sodium on emergence agitation during recovery from anesthesia in elderly patients undergoing radical resection of rectal cancer. Methods Seventy-two elderly patients undergoing radical resection of rectal cancer in Jinhua Central Hospital from January, 2014 to October, 2016 were randomly divided into observation group and control group. Intravenous injection of 0. 6 mg/kg parecoxib sodium was performed in the patients of observation group, while isodose saline for the patients of control group. The intravenous 0. 3 mg, 0. 05 mg/kg midazolam, fentanyl of 3 penehyclidine hydrochloride g/kg, (1-1. 5) mg/kg of propofol, 1 mg/kg atracurium was administrated in both groups for anesthesia induction. After successful endotracheal tube (ET) placement, propofol via an infusion pump, and intermittent intravenous fentanyl and CIS atracurium to maintain the EEG double frequency index (BIS) at 40-60 until the skin was sutured. The general condition, time to extubation, recovery time, stay in post anesthesia care unit (PACU), hemodynamics at each time points, and emergence agitation during recovery from anesthesia, PARD score and the incidence of adverse reactions were compared between the two groups. Results The stay in PACU of the observation group was shorter than that of the control group (P < 0. 05), however, there were no significant difference in the time to extubation and recovery (P > 0. 05); the MAP and HR levels at T2 and T3 of the observation group were lower than those of the control group; in the control group, MAP and HR levels at T2 and T3 were lower than that at T0 (P < 0. 05). The levels of MAP and HR at T0, T1 had no statistical significance between the two groups (P > 0. 05);PARD score, incidence of agitation and adverse reaction of the observation group were lower than those of the control group (P < 0. 05). Conclusion The pretreatment with parecoxib sodium can reduce the incidence rate of agitation and adverse reaction, and maintain the stable hemodynamics with a better safety elderly patients undergoing radical resection of rectal cancer.