帕瑞昔布钠用于不同年龄患儿日间手术后镇痛的适宜剂量  

Appropriate dosage of parexoxib sodium for postoperative analgesia in different ages children with day surgery

作　　者：高宝斌[1] 黄雅莹[1] 王伟[1] 彭文勇[1] 王晔恺[2] 连庆泉[1] 

机构地区：[1]温州医学院附属第二医院,325027 [2]浙江省舟山医院分子生物学实验室

出　　处：《中华麻醉学杂志》2011年第10期1178-1180,共3页Chinese Journal of Anesthesiology

摘　　要：目的探讨帕瑞昔布钠用于不同年龄患儿日间手术后镇痛的适宜剂量。方法拟行腹股沟斜疝、鞘膜积液手术患儿180例，ASA分级Ⅰ级，年龄1～12岁，均采用七氟醚全身麻醉联合髂腹股沟神经阻滞麻醉，根据不同年龄分为3组（n=60）：1—3岁组（Ⅰ组）、4—6岁组（Ⅱ组）和7—12岁组（Ⅲ组）；采用随机数字表法，每组随机分为A亚组和B亚组（n=30），于切皮即刻分别静脉注射帕瑞昔布钠0．5和1．0mg／kg。Ⅰ组采用面部表情加行为综合评分法（FLACC）、Ⅱ组采用语言表达与行为联合的东安大略儿童医院疼痛评分方法（CHEOPS）、Ⅲ组采用视觉模拟评分法（VAS）评价镇痛效果。FLACC评分≤3分、CHEOPS评分≤7分或VAS评分≤3分为镇痛有效。于术后6h（T1）、12h（T2）和24h（T3）时记录疼痛评分及术后24h内不良反应的发生情况。结果与B亚组比较，Ⅰ—A亚组T1时疼痛评分升高（P〈0．01），其余时点差异无统计学意义，Ⅱ-A亚组和Ⅲ-A亚组各时点疼痛评分差异无统计学意义（P〉0．05）；Ⅰ组术后镇痛有效率97％（Ⅰ-A亚组93％，Ⅰ-B亚组100％），Ⅱ组术后镇痛有效率100％，Ⅲ组术后镇痛有效率93％（Ⅲ-A亚组97％，Ⅲ-B亚组90％）。Ⅰ组～Ⅲ组的2个亚组间不良反应发生率比较差异无统计学意义（P〉0．05）。结论帕瑞昔布钠1．0和0．5mg／kg分别适于1～3岁和4～12岁患儿日间手术的术后镇痛。Objective To determine the appropriate dosage of parexoxib sodium for postoperative analgesia in different age children with day surgery. Methods One hundred and eighty ASA Ⅰ children aged 1-12 yr scheduled for day surgery undergoing sevoflurane anesthesia combined with lateral inguinal regional blockade were divided into 3 groups according to age （n = 60 each） ：group 1-3 yr （group Ⅰ ）, group 4-6 yr （group Ⅱ ） and group 7-12 yr （group Ⅲ ） .Eeach group was randomly divided into 2 sub-groups（ n = 30） ： parecoxib sodium 0.5 mg/kg （sub-group A） and parecoxib sodium 1.0 mg/kg （sub-group B）. Sub-groups A and B received iv injection of paracoxib sodium 0.5 or 1.0 mg/kg respectively immediately at skin incision. Analgesic effect was evaluated by FLACC score （group Ⅰ ）, CHEOPS score （group Ⅱ ） and VAS scroe （group Ⅲ） at 6（T1 ）, 12（T2）and 24 h （T3 ）after operation. The effective analgesia was defined as FLACC score ≤ 3, CHEOPS score ≤ 7 or VAS score ≤ 3. Side effects were also observed. Results Compared with sub-group B, FLACC score was significantly increased at Tt in sub-group Ⅰ -A （P 〈 0.01） . There was no significant difference in CHEOPS score or VAS score between sub-groups Ⅱ-A and Ⅱ-B, and between sub-groups m -A and m-B （ P 〉 0.05）. The incidence of effective analgesia was 97% in group Ⅰ （93% in group sub-group Ⅰ -A, 100% in sub-group Ⅰ -B）, 100% in group Ⅱ and 93% in group Ⅲ （97% in sub-group Ⅲ-A, 90% in sub-group Ⅲ-B）. There was no significant difference in the incidence of side effect between sub-groups Ⅰ-A and Ⅰ-B, between sub-groups Ⅱ-A and Ⅱ-B, and between sub-groups Ⅲ-A and Ⅲ-B （P 〉 0.05）. Conclusion Parecoxib sodium 1.0 or 0.5 mg/kg can be used in postoperative analgesia in children aged 1-3 yr or 4-12 yr with day surgery respectively.

关 键 词：环氧化酶2抑制剂 儿童 镇痛 门诊外科手术 

分 类 号：R614[医药卫生—麻醉学]