帕瑞昔布钠用于老年髋关节置换术后的镇痛效果和安全性  

Effectiveness and Safety of Parecoxib-sodium Treatment in Elderly Hip Replacement for Postoperative Analgesia

作　　者：卢园园[1] 徐红党[1] 周密[1] 黄志莲[1] 张旭彤[1] 李军[1] 

机构地区：[1]温州医学院附属第二医院麻醉科,325027

出　　处：《医学研究杂志》2012年第1期120-123,共4页Journal of Medical Research

摘　　要：目的研究帕瑞昔布钠用于老年髋关节置换术后的镇痛效果和安全性。方法择期行全(半)髋关节置换术患者60例,ASAⅡ或Ⅲ级,随机分为帕瑞昔布钠组(P组)和对照组(C组),n=30。两组患者在给予硬膜外1mg吗啡负荷量后,P组术后应用2天帕瑞昔布钠40mg,每日2次,静脉注射,C组行硬膜外病人自控镇痛(PCEA,0.15%罗哌卡因+吗啡2mg共100ml,2ml/h)。记录术后48h内各时点的静息和运动VAS评分及疼痛补救措施,记录术后不良反应和生化指标变化,行术后24、48h患者总体满意度评价。结果 P组仅术后24h静息VAS评分高于C组(P<0.05),而其余时点与C组比较差异无统计学意义(P>0.05);P组术后12、18、24、28、36、48h时点运动VAS评分明显低于C组(P<0.05),且术后24、48h镇痛评价"非常好"比率明显优于C组(P<0.05),而术后瘙痒、恶心呕吐、心动过速、低血压、发热的发生率均低于C组(P<0.05)。结论髋关节置换术后静脉使用帕瑞昔布钠40mg,每日2次静脉注射,可以提供良好的镇痛效果,提高患者总体满意度,减少不良反应。To observe the effectiveness and safety of parecoxib treatment in elderly hip replacement for postoperative an-algesia. Methods Totally 60 cases of patients with ASA Ⅱ or Ⅲ scheduled for hip replacement were randomly divided into group pare- coxib（group P） and group control（group C） ,with 30 cases in each group. All patients in two groups received combined spinal and epi- dural anesthesia in operation and were given epidural ropivacaine 0, 25% injection 5ml（which include morphine ling） as a loading dose at 0.5h before the end of surgery. Patients in group P received intravenously parecoxib - sodium 40rag bid for 2 days postoperation. Patients in group C received patient - controlled epidural analgesia （PCEA） which includes 0.15% ropivacaine and morphine 2mg injection 100ml （0.5ml/bolus, lock time 15rains）. Postoperative analgesia efficacy was assessed by visual analog scales（VAS） at PACU, 2, 4, 6, 8, 10, 12, 18, 24, 28, 36 and 48h after surgery. The patients＇ global satisfaction of postoperative analgesia was evaluated at 24h and 48h after surgery. The safety was evaluated including vital signs, adverse effect and clinical laboratory test. The number and time of rescue medication was recorded. Results The rest VAS scores at 24h after surgery were higher in group P compared with those in group C（P 〈 0.05 ）. The motion V AS scores at 12,18,24,28,36h and 48h after surgery were significantly lower in group P than those in group C （P 〈 0.05）. There was no rescue analgesia medication in two groups. The rate of patients＇ global satisfaction of postoperative analgesia which in ＂excellent＂ and ＂good＂ was significantly better in group P than that in group C （ P 〈 0.05）. The incidence of nausea, vomiting, pitch, tachycardia, hypotensiou and postoperative fever were significantly lower in group P than those in group C （P 〈 0.05）. Conclusion Parecoxib 40mg given IV twice a day for two days can provides a good analgesia affect and improves global satisfaction of p

关 键 词：帕瑞昔布髋关节置换镇痛效应安全性 老年 

分 类 号：R473.6[医药卫生—护理学]