帕瑞昔布钠超前镇痛在瑞芬太尼复合异丙酚全凭静脉麻醉下妇科腹腔镜手术中的应用  

Preemptive Analgesic Effect of Parecoxib on Patients Undergoing Laparoscopy Maintained with Remifentanil and Propofol Total Intravenous Anesthesia

作　　者：叶健鸿[1] 彭俊[2] 李偲[1] 刘宽智[1] 黄文起[1] 

机构地区：[1]中山大学附属第一医院麻醉科,510080 [2]中山大学附属第二医院麻醉科

出　　处：《岭南急诊医学杂志》2010年第3期217-219,共3页Lingnan Journal of Emergency Medicine

摘　　要：目的:研究帕瑞昔布钠超前镇痛在瑞芬太尼复合异丙酚全凭静脉麻醉下妇科腹腔镜手术中的应用。方法:60例ASA Ⅰ～Ⅱ级行择期妇科腹腔镜手术患者随机分为三组各20例。对照组(C组)麻醉诱导前20 min静注生理盐水10 mL;超前镇痛组(P组)麻醉诱导前20 min静注帕瑞昔布钠40 mg:常规镇痛组(R组)术毕前20 min静注帕瑞昔布钠40 mg。分别记录拔管后0、1、2、4、6、12、24 h的视觉模拟评分法(VAS)评分及拔管后5、10、15、20 min的Rammesay镇静评分;记录术后24 h内追加镇痛药及不良反应的情况。结果:P组在拔管后0、1、2、4、6、12 h时点的VAS评分低于C组同时点(P<0.05);拔管后0、1、2、4、6h的VAS评分,P组低于R组(P<0.05);而P组及R组在术后5、10、15、20 min时点的镇静评分高于C组同时点(P<0.05),P组在5、10 min时的镇静评分高于R组同时点(P<0.05)。结论:帕瑞昔布钠用于瑞芬太尼复合异丙酚全凭静脉麻醉下的妇科腔镜手术,超前镇痛效果确切、安全。Objective： To evaluate the preemptive analgesic effect and safety of parecoxib sodium on patients undergoing laparoscopy maintained with remifentanil and propofol total intravenous anesthesia （TIVA）.Methods： Sixty ASA I or II gynecological patients scheduled for elective laparoscopy were randomly allocated into three groups （n= 20 each）. Control group （C） received normal saline 10mL,i.v injection 20 min before induction. Preemptive analgesia group （P） received parecoxib sodium 40 mg,i.v injection 20 min before induction. Regular Group （R） received parecoxib sodium 40 mg,i.v injection 20 min before the end of surgery. Pain score （VAS） was recorded at 0,1,2,4, 6,12 and 24 h after extubation. The score of sedation was evaluated by Rammesay system at 5,10,15 and 20 rain after surgery. Meanwhile, the usage of analgesics and side effect during the first 24h after extubation were recorded. Results： The VAS in group P was lower than that not only in group C （P〈0.05） at 0,1,2,4,6 and 12 h after extubation but also in group R （P〈0.05） at 0, 1,2,4 and 6h after extubation. The sedation scores in both group P and R were significantly higher than that in group C at the time point 5,10,15,20 min （P〈0.05） while scores in group P were higher than that in group R at the time point 5 and 10 min. Conclusion： Parecoxib sodium can provide safe preemptive analgesic effect to patients undergoing laparoscopy maintained with remifentanil and propofol TIVA.

关 键 词：帕瑞昔布钠 超前镇痛 腹腔镜手术 全凭静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]