氨酚羟考酮、塞来昔布用于腹腔镜胆囊切除术后镇痛的临床研究  

Comparing of oral administration of oxycodone/acetaminophen and celecoxib on postoperative pain in laparoscopic cholecystectomy

作　　者：彭宇[1] 蒋宗滨[1] 方懿[1] 朱天琦[1] 张夏[1] 张明明[1] 

机构地区：[1]广西医科大学疼痛医学中心,南宁市530021

出　　处：《实用疼痛学杂志》2010年第1期13-16,共4页Pain Clinic Journal

基　　金：广西研究生教育创新计划资助项目（2009105981002M218）

摘　　要：目的 探讨围术期口服氨酚羟考酮和塞来昔布治疗腹腔镜胆囊切除术后疼痛的有效性和安全性.方法 选择腹腔镜胆囊切除手术60例.随机分成3组,即氨酚羟考酮组（A组）、塞来昔布组（B组）和安慰剂（维生素E胶丸）组（C组）,每组20例.予以手术前8 h、术后当日及术后第1、2日给药.三组患者均以单次肌注曲马朵100 mg作为术后疼痛的补救措施.观察并记录患者术后疼痛评分（VAS）、镇静评分和曲马朵用量,同时记录患者的胃肠运动情况及所出现的不良反应.结果 A组和B组除在术后48 h时间点外.其余各时问点静息下的VAS均低于C组（P〈0.05）;A组和B组之间静息下的VAS没有统计学差异（P〉0.05）;A组和B组在各时点活动时的VAS均低于C组（P〈0.05）;A组在术后12h、24h、48h 活动时的VAS低于B组（P〈0.05）;A组和B组曲马朵补救用量明显低于C组（P〈0.05）;A组和B组均无1例使用曲马朵;三组不良反应的发生率无统计学差异（P〉0.05）.结论 围术期口服氨酚羟考酮和塞来昔布用于腹腔镜胆囊切除术后镇痛治疗安全、有效;氨酚羟考酮对于缓解术后活动时疼痛优于塞来昔布.Objective To investigate the safety and efficacy of postoperative analgesia using oral administration of oxycodone/acetaminophen and celecoxib in patients with laparoscopic cholecystectomy. Methods Sixty patients undergoing laparoscopic cholecystectomy were divided into three groups randomly,oxycodone/acetaminophen group （group A）, celecoxib group （group B） and placebo-controlled group （group C）,with 20 cases in each. Patients were given the medicines at the time of 8 hours prior to surgery, the day of surgery, and the following two days. tramadol 100 mg was provided for all the groups by intramuscular injection if the patients still felt pain. Visual analogue scale（VAS）, sedation score, tramadol consumption, gastrointestinal function and the side effects were observed and recorded after the surgery. Results The VAS in group A and group B were lower than that in group C at the time of 30 min after waking up, 6 hours,12 hours and 24 hours after surgery during rest （P〈0.05）, the VAS in group A and group B showed no significant difference at the same time during rest （P〉0.05）. The VAS in group A and group B were lower than that in group C at all the time when moving（P〈0.05）. The VAS in group A was lower than that in group B at the time of 12 hours, 24 hours and 48 hours after surgery （P〈0.05）. The tramadol consumption in group A and group B were significantly lower than that in group C （P〈0.05）. No tramadol in group A and group B was used. There was no significant difference in the side effects among the three groups （P〉0.05）. Conclusions It was effective and safe that oral administration of oxycodone/acetaminophen and celecoxib in perioperative analgesia after laparoscopic cholecystectomy. The analgesic effect of oxycodone/acetaminophen is better than that of celecoxib when patients moving.

关 键 词：氨酚羟考酮 塞来昔布 胆囊切除术 腹腔镜 疼痛 手术后 镇痛 

分 类 号：R657.4[医药卫生—外科学]