帕瑞昔布用于老年患者腹腔镜胆囊切除术后镇痛效果观察  

Observation of postoperative analgesic effects of intravenous parecoxib in gerontal patients undergoing laparoscopic cholecystectomy

作　　者：张宏业[1] 左明章[1] 

机构地区：[1]卫生部北京医院麻醉科,100730

出　　处：《中华老年医学杂志》2011年第8期654-656,共3页Chinese Journal of Geriatrics

摘　　要：目的观察围术期应用帕瑞昔布对老年患者腹腔镜胆囊切除术后镇痛效果的影响。方法前瞻性、随机、双盲、安慰剂对照、平行分组研究，选择美国麻醉医师协会（ASA）病情评估分级标准I或Ⅱ级的择期全麻下行腹腔镜胆囊切除手术患者40例，年龄60～80岁，随机分为帕瑞昔布组和安慰剂组，每组20例，帕瑞昔布组于手术前10min、手术后12h和24h分别静脉注射帕瑞昔布40mg，安慰剂组于手术前10min、手术后12h和24h分别静脉注射生理盐水5ml，用视觉模拟评分法（VAs）观察术后2h、4h、6h、12h、24h的疼痛强度和患者对镇痛的满意度。结果与安慰剂组比较，帕瑞昔布组的术后2h、4h、6h、12h和24h的VAS评分明显降低（均P〈0．05）。帕瑞昔布组24h镇痛满意度（8．1±1．2）分，高于安慰剂组（5．2±0．9）分，差异有统计学意义（t=7．402，P〈0．05）。结论静脉注射帕瑞昔布用于老年患者腹腔镜胆囊切除手术，能有效缓解术后疼痛，提高患者术后镇痛质量。Objective To observe-the postoperative analgesic effects of perioperative intravenous parecoxib in gerontal patients undergoing laparoseopie cholecystectomy. Methods A prospective, randomized, double-blind, placebo-controlled, parallel group study was performed. The 40 American Society of Anesthesiologists （ASA） I or II patients （aged 60-80 years） undergoing elective laparoscopic choleeysteetomy under general anesthesia were randomly allocated to 2 groups （n= 20, each） ： the parecoxib group received intravenous parecoxib 40 mg at 10 minutes before incision and 12 hours and 24 hours after incision; however, the placebo group received 5 ml normal saline instead of parecoxib at the same time. The intensity of algesia was measured using visual analogue scale （VAS） scores （1-10, 0=no pain, 10=worst pain）, and was recorded at 2, 4, 6, 12, 24 hours after operation. The patients＇ global evaluation of postoperative analgesia was recorded and compared between ＂the two groups. Results The VAS scores at the different time points were significantly less in parecoxih group than in placebo group （all P 〈 0.05）. The patients＇ global evaluation of postoperative analgesia was higher in parecoxib group than in placebo group （（8.1 ± 1.2） scores vs. （5.2 ± 0.9 ） scores, t = 7. 402, P 〈0.05）. Conclusions Intravenous parecoxib can effectively relieve postoperative algesia and improve postoperative analgesia after laParoscopic cholecystectomy.

关 键 词：环加氧酶抑制药 镇痛 胆囊切除手术 腹腔镜 

分 类 号：R614[医药卫生—麻醉学]