帕瑞昔布对颈椎前路手术的镇痛效果的影响  

Analgesia effect of parecoxib on postoperative pain in patients undergoing anterior approach cervical surgery

作　　者：韩彬[1] 贾东林[1] 于琳琳[1] 王军[1] 

机构地区：[1]北京大学第三医院麻醉科,北京100191

出　　处：《中国临床药理学杂志》2011年第10期749-751,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察颈椎前路手术患者应用帕瑞昔布对术后镇痛的影响。方法按美国麻醉学会分级(ASA)标准,90例Ⅰ～Ⅱ级的择期行颈椎前路手术患者,随机分为3组:安慰剂组、术前用药组、术后用药组。用视觉模拟评分(VAS)法测定静注帕瑞昔布后24,,122,4 h的疼痛程度,并记录各时间点不良反应情况,以及患者对镇痛的总体满意度。结果与安慰剂组相比,术前给药组及术后给药组在术后2,4,12,24 h的VAS评分均降低;术后24 h患者满意度明显提高;同时,在术后41,2 h时,术前给药组VAS评分较术后给药组低(P<0.05)。结论静脉给予帕瑞昔布钠40 mg,可减轻颈椎前路手术后疼痛,降低不良反应发生率,且术前使用较术后使用效果更佳。Objective To investigate the effects of parecoxib in postoperative pain management in patients undergoing anterior approach cervical surgery.Methods Ninety ASA（American Society of Anesthesiology） physical status Ⅰ and Ⅱ adult patients undergoing elective anterior approach cervical surgery were included in this study.Patients were randomly allocated into three groups： group I,saline 2 mL injected intravenously 30 min prior to surgery;group Ⅱ,parecoxib 40 mg injected intravenously prior to surgery;and group Ⅲ,parecoxib 40 mg injected at the end of the surgery.The severity of postoperative pain at 2,4,12 and 24 h after administration of parecoxib was measured by VAS scales,and the adverse effects and the patients′ overall satisfaction were recorded.Results Compared with group Ⅰ,the VAS scores in group Ⅱ and group Ⅲ were decreased at 2,4,12,24 h after surgery.The number of patients who required extra postoperative analgesics was significantly lower,and the overall satisfaction was significantly increased,while incidence of adverse effects decreased in group Ⅱ and Ⅲ.The VAS scores in group Ⅱ were lower than group Ⅲ at 4 and 12 h after surgery（P〈0.05）.Conclusion The administration 40 mg of parecoxib may lower the postoperative pain after anterior approach cervical surgery and the incidence of adverse effects.Compared with postoperative adiminastration of parecoxib,preoperative administration exhibits more effective analgesia in this group of patients.

关 键 词：帕瑞昔布 颈椎手术 镇痛 

分 类 号：R614.24[医药卫生—麻醉学] R971.2[医药卫生—外科学]