帕瑞昔布钠联合地塞米松对全麻苏醒期不良反应的影响  

Effect of Parecoxib Sodium Combined with Dexamethasone on recovery from adverse reaction to general anesthesia

作　　者：姜芸[1] 张昱[1] 蒋晖[1] 

机构地区：[1]新疆医科大学附属肿瘤医院ICU,830011

出　　处：《中国实用医药》2012年第7期10-11,共2页China Practical Medicine

摘　　要：目的探讨帕瑞昔布钠联合地塞米松对全麻苏醒期不良反应的影响。方法全身麻醉下行择期乳腺癌改良根治术患者80例,随机分为四组:帕瑞昔布钠组(P组)、地塞米松组(D组)、帕瑞昔布钠联合地塞米松组(C组)、生理盐水组(N组)。观察并记录四组患者:①麻醉前(T0)、拔管时(T1)、拔管后5min(T2)、拔管后10min(T3)四个时点四组患者的平均动脉压(MAP)、心率(HR);②拔管后反应:镇痛及舒适度情况(疼痛评分(PS)、躁动评分(RS)、镇静评分(RSS)、全麻后身体舒适度评分(BCS))。结果①各时点MAP与HR比较:①组间比较:T1、T2时点,P组、D组及C组MAP、HR均低于N组(P<0.01),其中,C组与P组、D组差异有统计学意义(P<0.01);T3时点P组、D组及C组MAP、HR均低于N组(P<0.01)。②组内比较:各组MAP、HR均在T1时点最高,T2、T3时点有所下降;D组在T1,T2时点的差异均有统计学意义(P<0.05);C组T1时点MAP、HR高于其余时间点(P<0.05);P组、N组四个时点之间的差异均有统计学意义(P<0.05)。③四组患者拔管后反应比较:P组、C组疼痛评分(PS)、躁动评分(RS)明显低于D组和N组(P<0.05);镇静评分(RSS)、全麻后身体舒适度评分(BCS)明显高于D组和N组(P<0.05)。结论帕瑞昔布钠及地塞米松均可减轻全麻患者拔管期间的心血管反应,两者联合应用作用效果优于单独使用帕瑞昔布钠或地塞米松。Objective To investigate effect of Parecoxib Sodium combined with Dexamethasone on recovery from adverse reaction to general anesthesia.Methods Eighty cases of patients, scheduled for selective modified radical mastectomy under general anesthesia, were randomly divided into four groups： Parecoxib Sodium group （group P）, Dexamethasone group （group D）, Dexamethasone combined with Parecoxib Sodium group （group C） and control group （group N）. Data of the four groups were observed and recorded. ①The MAP and HR before anesthesia （T0）, at extubation （T1）, 5 min after extubation （T2）, 10 min after extubation （T3） in four groups;②Reaction after extubation： the status of pain and comfort （PS, RS, RSS, BCS）. Results ① Comparison between MAP and HR at each time point： ① Group comparison： MAP and HR at T1,T2 in group P, group D, and group C were lower than that in group N （P〈0.01）, and the variance among group C, P and D was of statistical significance （P〈0.01）; MAP and HR at T3 in group P, D and C were lower than that in group N （P〈0.01）.② Comparison in groups： MAP and HR in all groups were the highest at T1, and declined at T2 and T3.There was statistical significance at T1 and T2 in group D （P〈0.05）.MAP and HR were higher at T1 than at other points in group C （P〈0.05）. The difference at each time point was of statistical significance between group P and group N. ③Comparison of the reactions after extubation among the four groups： PS and RS in group P and C were obviously lower than those in group D and N （P〈0.05）, but RSS and BCS were inverse （P〈0.05）. Conclusion Both dexamethasone and Parecoxib Sodium can relieve the cardiovascular effects in extubation. Combined effect of the two is better than dexamethasone or Parecoxib Sodium alone.

关 键 词：帕瑞昔布钠 地塞米松 拔管反应 

分 类 号：R614[医药卫生—麻醉学]