帕瑞昔布钠在膝关节镜手术中的应用  

Application of parecoxib sodium during arthroscopic knee surgery

作　　者：郑寅曦[1] 徐宏伟[1] 刘进[1] 

机构地区：[1]四川大学华西医院麻醉科,成都610041

出　　处：《山西医科大学学报》2012年第4期312-315,共4页Journal of Shanxi Medical University

摘　　要：目的探讨帕瑞昔布钠是否适用于短小膝关节镜手术。方法择期行膝关节镜下半月板修整成形术和膝关节清理术患者60例,按数字表法随机分为帕瑞昔布钠组(P组)和对照组(C组),每组30例。股神经阻滞实施成功后,P组于手术实施前15 min静脉注入帕瑞昔布钠40 mg(生理盐水稀释至5 ml),C组给予生理盐水5 ml。术中采用TCI泵注异丙酚镇静。记录两组患者入室、诱导后、手术开始、术中、关节镜退出时、手术结束、出室时的心率(HR)、收缩压(SBP)、舒张压(DBP)、脉搏血氧饱和度(SpO2),以及异丙酚总用量、患者苏醒时间、术中和术后的相关不良反应。结果两组患者的流行病学资料无统计学差异。P组比C组异丙酚使用量减少[(163.6±65.2)mg vs(204.7±74.1)mg,P<0.05],P组较C组术中发生呼吸抑制的比例(16.7%vs 66.7%,P<0.001)及发生体动的比例(16.7%vs 70.0%,P<0.001)明显降低。两组患者术中血流动力学无明显波动,组间各时点血流动力学指标、苏醒时间及术后不良反应无统计学差异。结论膝关节镜术前使用帕瑞昔布钠能减少术中异丙酚的用量,使股神经阻滞复合异丙酚TCI镇静成为一种更安全、高效的麻醉方式。Objective To explore the feasibility of parecoxib sodium in arthroscopic knee surgery. Methods Sixty patients undergoing arthroscopic meniscus repair or arthroscopic debridement were randomly assigned into parecoxib sodium group and control group.After femoral nerve block,patients in parecoxib sodium group were intravenously administered 40 mg parecoxib sodium（diluted by 5 ml normal saline） 15 min before operation,while patients in control group were injected with 5 ml normal saline.The hemodynamic variables,dosage of propofol,recovery time and perioperative side effects were observed. Results The demographic characteristics were similar in 2 groups.Dosage of propofol was less in parecoxib sodium group than in control group[（163.6±65.2）mg vs（204.7±74.1）mg,P0.05].The incidence of respiratory inhibition（16.7% vs 66.7%,P0.001）and body movement during operation（16.7% vs 70.0%,P0.001） were significantly lower in parecoxib sodium group than in control group.Hemodynamics of patients during operation kept steady,and there was no significant difference between two groups in the term of hemodynamic parameters at each time point,awakeness time and postoperative side effects. Conclusion Parecoxib sodium given before arthroscopic surgery can reduce the dosage of propofol,and therefore femoral nerve block with propofol-TCI for sedation might be a more safe and efficient anesthesia modality.

关 键 词：帕瑞昔布钠 股神经阻滞 膝关节镜手术 

分 类 号：R614.4[医药卫生—麻醉学]