帕瑞昔布钠对肿瘤术后患者吗啡镇痛的影响  

Efficacy of parecoxib sodium on analgesic of postoperative in patient-controlled analgesia with morphine in patients undergoing tumor surgery

作　　者：黄礼兵[1] 季淑娟[1] 姚凤珍[1] 赵峰[1] 崔苏扬[1] 

机构地区：[1]南京中医药大学附属医院麻醉科

出　　处：《临床麻醉学杂志》2010年第5期397-399,共3页Journal of Clinical Anesthesiology

摘　　要：目的 评价帕瑞昔布钠不同方式给药对肿瘤患者术后吗啡镇痛的影响.方法 60例择期肿瘤手术患者随机分为三组,每组20例.A组切皮前15 min、术后12 h静脉注射帕瑞昔布钠40 mg;B组关腹时、术后12 h静脉注射帕瑞昔布钠40 mg;C组不用帕瑞昔布钠作为对照.三组术后均应用吗啡行患者自控镇痛（PCA）.记录PACU（麻醉恢复室）停留期间、首次要求镇痛时间、术后2、4、12、24、48 h的VAS评分,48 h吗啡用量以及不良反应.结果 A组和B组术后2、4 h的VAS评分低于C组（P〈0.05）,A组术后12 h的VAS评分低于B、C组（P〈0.05）;A、B组患者在PACU要求镇痛人数较C组显著减少（P〈0.05）;A、B组患者首次需求镇痛时问较C组延长,而A组明显长于B组（P〈0.05）;与C组比较.A、B组术后48 h吗啡用量显著减少,且A组少于B组（P〈0.05）;三组不良反应发生率差异无统计学意义.结论 在肿瘤患者术后镇痛中,帕瑞昔布钠能够在减少吗啡用量的基础上提供更好的镇痛效果,而且切皮前给药比关腹时给药更有优势.Objective To evaluate the effects of parecoxib sodium on analgesic efficacy of postoperative patient-controlled analgesia with morphine in patients undergoing tumor surgery. Methods Sixty patients undergoing digestive tract tumor surgery were randomly assigned to three groups. Pareeoxib 40 mg was intravenously injected at 15 rain before skin incision and 12 h after operation in group A,which was injected before the end of surgery and 12 h after operation in group B. The patients in group C were not given parecoxib sodium as the controls. Three groups received postoperative PCA with morphine. The visual analogue score（VAS）, morphine consumption and side effects were recorded during the period of postoperative 48 hours. Results Compared with group C, groups of A and B exhibited lower VAS points at 2 h, 4 h after operation. The VAS of group A was significantly lower than that of groups of B and C at 12 h after operation. Patients needed analgesics during PACU stay were less in group A than that in groups of B and C（P^0. 05）. The delay for first analgesic demand was increased in groups of A and B compared with that in group C,which was longer in group A than that in group B （P^0. 05）. 48h morphine consumption in groups of A and B was significantly less than that in group A, which was less in group A than that in group B（P〈0.05）. Conclusion Additional injection of pareeoxib sodium, especially given before skin incision, provides better analgesic effect and reduces morphine consumption in patients undergoing PCA with morphine.

关 键 词：帕瑞昔布钠 镇痛 

分 类 号：R614[医药卫生—麻醉学]