帕瑞昔布钠对骨科蛛网膜下腔阻滞麻醉患者术后镇痛的作用  

Analgesic effects of parecoxib sodium after orthopedic subarachnoid block anesthesia

作　　者：陈黎虬[1] 邓敦[1] 颜海波[1] 王朝晖[1] 张文斌[1] 张维康[1] 竺利民[1] 陈笑宇[1] 颜佩华[1] 李登斐[1] 黄华芳[1] 

机构地区：[1]温州医学院附属温岭医院骨科,317500

出　　处：《中华创伤杂志》2012年第4期353-356,共4页Chinese Journal of Trauma

基　　金：温岭市科技局重点科研资助项目（2009WLCB0056）

摘　　要：目的探讨帕瑞昔布钠联合硬脊膜外自控镇痛（patientcontrolledepiduralanalgesia，PCEA）对骨科蛛网膜下腔阻滞麻醉患者术后镇痛效果。方法200例骨科蛛网膜下腔阻滞麻醉手术患者按随机数字表法分为帕瑞昔布钠治疗组（P组）、曲马多对照组（C组），每组各100例。P组于手术结束时静脉注射帕瑞昔布钠40mg＋PCEA，C组使用曲马多注射液0．5g＋PCEA。两组均于手术结束离室时启用PCEA镇痛。对两组术后6，12，24，48，72h进行视觉模拟疼痛评分（VAS），记录镇痛泵按压次数、有效次数及不良反应和满意度。．结果术后6，12，24，48，72hVAS评分P组低于C组（P〈0．05）；12，24h镇痛泵按压次数、有效次数及不良反应P组均低于C组，满意度P组高于C组（P〈0．05）。结论帕瑞昔布钠联合PCEA对骨科蛛网膜下腔阻滞麻醉患者术后镇痛效果更佳，不良反应发生率较低。Objective To investigate the analgesic effects of parecoxib sodium combined with patient controlled epidural analgesia （PCEA） after orthopedic subarachnoid block anesthesia surgery. Methods Two hundred patients undergone orthopedic subarachnoid block anesthesia surgery were ran- domly and equally divided into two groups ： Group P （ treated intravenously with 40 mg parecoxib sodium combined with PCEA at the end of operation） and Group C （ treated intravenously with 0.5 g tramadol combined with PCEA at the end of operation）. The visual analog scale （VAS） was performed at 6, 12, 24, 48 and 72 hours postoperatively in two groups. Meanwhile, the press frequency of analgesic pump, effective frequency, side effects and satisfaction degree were recorded. Results The VAS sore of Group P was lower than that of Group C at 6, 12, 24, 48 and 72 hours postoperatively （P 〈 0.05）. Group P showed a less number in aspects of the press frequency of analgesic pump, effective frequency, and side effects at 12 and 24 hours, but a higher satisfactory degree, compared with Group C （P 〈 0.05 ）. Conclusion Combined use of pareeoxib sodium and PCEA can exert a better analgesic effect and have a low incidence rate of side effects following orthopedic subarachnoid block anesthesia.

关 键 词：麻醉和镇痛 外科手术 帕瑞昔布钠 

分 类 号：R614[医药卫生—麻醉学]