帕瑞昔布钠切皮前给药对肿瘤外科患者术后吗啡镇痛的影响  

Clinical efficacy of preincisional parecoxib sodium on postoperative morphine analgesia in patients undergoing the digestive tract tumor surgery

作　　者：季淑娟[1] 赵峰[1] 黄礼兵[1] 崔苏扬[1] 

机构地区：[1]南京中医药大学附属医院麻醉科,南京210029

出　　处：《实用药物与临床》2010年第1期16-17,共2页Practical Pharmacy and Clinical Remedies

摘　　要：目的评价帕瑞昔布钠切皮前镇痛对肿瘤外科患者术后吗啡镇痛的影响。方法择期行肿瘤外科手术患者40例,年龄45～74岁,ASAⅠ～Ⅱ级,随机分为2组(n=20):切皮前镇痛组(Pre组)和对照组。静脉注射咪达唑仑、丙泊酚、芬太尼、维库溴铵麻醉诱导,吸入七氟烷,间断给予芬太尼或维库溴铵维持麻醉。Pre组切皮前15 min静脉注射帕瑞昔布钠40 mg,术毕两组患者均采用吗啡患者自控镇痛(PCA)。记录术后2、4、8、12、24 h的视觉模拟评分(VAS)、首次PCA时间、术后24 h吗啡用量和不良反应发生情况。结果与对照组比较,切皮前镇痛组术后各时点VAS评分明显降低,首次PCA时间延长,术后24 h吗啡用量减少(P<0.05),不良反应组间差异无统计学意义(P>0.05)。结论帕瑞昔布钠40mg切皮前给药,可以提高肿瘤外科患者术后镇痛效果,减少吗啡用量,有利于患者恢复。Objective To evaluate the clinical efficacy of preincisional parecoxib sodium on postoperative morphine analgesia in patients undergoing the digestive tract tumor surgery. Methods Forty ASAⅠ～Ⅱ patients undergoing digestive tract tumor surgery were randomly divided into two groups ：preincisional group（ Pre group）and control group. Anesthesia was induced with propofol, midazolam, fentanyl and vecuronium and maintained with sevoflurane inhalation and intravenous fentanyl or vecurordum. All patients received patient controlled analgesia （PCA） with morphine. Visual Analogue Score（VAS） at 2,4,8,12 ,24 h postoperatively, time to first analgesia demand, morphine consumption at 24 h after operation and side effects were recorded. Results Compared with control group, Pre group exhibited lower VAS scores at the recorded time points, prolonged time to first analgesia demand and less 24 hour morphine consumption（P 〈 0. 05 ）. There was no significant difference between the two groups as to side effects （P 〉 0.05 ）. Conclusion Preincisional parecoxib sodium provides better analgesic effect while decreasing postoperative morphine consumption in patients undergoing digestive tract tumor surgery.

关 键 词：帕瑞昔布钠 超前镇痛 吗啡 患者自控镇痛(PCA) 

分 类 号：R614[医药卫生—麻醉学]