帕瑞昔布在胆囊切除术后的镇痛效应观察  

Postoperative analgesia with parecoxib in patients underwent cholecystectomy

作　　者：孙文晋[1] 杭黎华[1] 邵东华[1] 吴进[1] 

机构地区：[1]江苏大学附属人民医院麻醉科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2011年第5期416-418,422,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:观察帕瑞昔布在开腹胆囊切除术后的镇痛效应,及其对患者血糖的影响。方法:择期开腹行胆囊切除术患者60例,随机分成3组,每组20例。未镇痛组,不施行镇痛;帕瑞昔布组,手术结束前30 min静脉注射帕瑞昔布40 mg;芬太尼组,使用芬太尼经静脉自控镇痛。分别于术后3,6,12,24 h观察3组患者的VAS评分,同时检测术前及术后0,3,6,24 h血糖水平。结果:术后3,6,12,24 h四个时点的VAS评分及术后3 h的血糖,帕瑞昔布组和芬太尼组显著低于未镇痛组(P<0.01),但帕瑞昔布组和芬太尼组间差异无统计学意义(P>0.05)。结论:静脉注射帕瑞昔布40 mg能有效地抑制开腹胆囊切除术后疼痛,其效果与使用芬太尼PCIA术后镇痛相似,且能很好地抑制术后3 h应激性高血糖反应。Objective： To assess the analgesic effect of parecoxib in patients underwent cholecystectomy and its effect on blood glucose.Methods： Sixty patients scheduled for cholecystectomy were randomized into three groups,with 20 patients in each group： Group A,there was no postoperative analgesia executed;Group B,parecoxib 40 mg was injected intravenously 30 min before the end of the surgery;Group C,fentanyl patient controlled intravenous analgesia（PCIA） eased pain.The degree of the postoperative pain was assessed at 3,6,12 and 24 h after surgery,using a visual analog scale,and the level of blood glucose was also recorded at preoperative and postoperative 0,3,6 and 24 h.Results： The pain scores of Group B and C at postoperative 3,6,12 and 24 h,and their level of blood glucose at postoperative 3 h were significantly lower than Group A（P0.01）,but there was no significant difference between group B and C（P0.05）.Conclusion： Administration of intravenous parecoxib 40 mg could significantly reduce postoperative pain in patients underwent cholecystectomy.The effects were the same as fentanyl PCIA and it could significantly reduce hyperglycemia of stress response at 3h point after operation.

关 键 词：帕瑞昔布 胆囊切除术 术后镇痛 血糖 

分 类 号：R971.2[医药卫生—药品]