芬太尼联合帕瑞昔布对盆腔及下腹部手术后镇痛的效果观察  

Analgesic Effects of Fentanyl Combined with Parecoxib on Patients after Pelvic and Lower Abdominal Surgery

作　　者：陈燕[1] 江海霞[1] 彭珮华[1] 秦婷婷[1] 

机构地区：[1]昆明医学院第一附属医院麻醉科,云南昆明650032

出　　处：《昆明医学院学报》2009年第9期118-121,共4页Journal of Kunming Medical College

摘　　要：目的比较芬太尼PCIA与帕瑞昔布+芬太尼PCIA应用于下腹部手术后镇痛的效果及部分不良反应发生情况.方法28例ASAⅠ～Ⅱ级全麻下行盆、腹部手术的患者,分为A组单纯芬太尼组,B组帕瑞昔布+芬太尼组,每组14例.两组于气管导管拨除后芬太尼静脉PCA镇痛(100mL溶液内含芬太尼1mg,B组缝皮前静注帕瑞西布40mg(生理盐水4mL稀释).记录术后24h芬太尼用量、PCA的次数(实际次数及有效次数),于术后4h,24h随访病人,进行VSA评分,询问恶心、呕吐等不良反应发生情况.结果B组24hPCA次数及芬太尼用量低于A组,VAS评分术后4h两组相比,B组VAS评分低于A组:术后24h两组相比差异无统计学意义(P>0.05).B组恶心呕吐及皮肤搔痒的实际发生频数低于A组.结论芬太尼PCIA+帕瑞昔布联合用于下腹部手术的术后镇痛安全、有效,值得在临床推广应用.Objective To compare the analgesic effects of fentanyl and parecoxib （via one bolus intravenous administration） combined with fentanyl and patient controlled intravenous analgesia （PCIA） after pelvic and lower abdominal surgery. Methods Twenty-eight patients, ASA class Ⅰ or Ⅱ , undergoing pelvic and lower abdominal surgery under general anesthesia, were randomly divided into group A （fentanyl used） and B （parecoxib combined with fentanyl used）, fourteen ones per group. To treat postoperative pain, all patients received fentanyl via PCIA after surgery respectively. All the patients received postoperative visits at 4 h and 24 h respectively, meanwhile, the dose of fentanyl, using frequency of PCA （by times） , VAS （visible analgesia score） , and the incidence of nausea, vomiting and skin itch were recorded respectively. At the terminal of the surgery, the patients in group B was administered one bolus of parecoxib （40mg, diluted by 4ml N.S.） intravenously before PCIA. Results Dose of fentanyl, times of PCA , VAS in group B were significantly less than those in group A （P 〈 0.05 ）. At 4h after surgery, the incidence of nausea, vomiting and skin itch in group B was lower than that in group B respectively （P 〈 0.05） nausea and vomiting between the two groups at 24 h after ; while there was no statistical difference in incidence of surgery （P 〉 0.05）. Conclusion Fentanyl combined with parecoxib is safe and effective on analgesia after lower abdominal surgery. It＇ s worth of application in clinic.

关 键 词：芬太尼 帕瑞昔布 术后镇痛 

分 类 号：R971.2[医药卫生—药品] R614.2[医药卫生—药学]