帕瑞昔布钠用于椎间盘髓核摘除术后镇痛的临床分析  

Clinical Analysis of Sodium Parecoxib for Postoperative Anaesthesia in Lumbar Intercalated Nuclear Surgery

作　　者：朱平增[1] 朱军[2] 丁建强[2] 焦岩[1] 杨彦军[1] 贾真[1] 

机构地区：[1]武警河南总队医院麻醉科,郑州450052 [2]武警河南总队医院药剂科,郑州450052

出　　处：《中国药房》2012年第42期3990-3992,共3页China Pharmacy

摘　　要：目的:观察帕瑞昔布钠用于椎间盘髓核摘除术患者术后镇痛的临床效果及安全性。方法:120例拟行椎间盘髓核摘除术患者随机分为帕瑞昔布钠术前组(Ⅰ组)、帕瑞昔布钠术后组(Ⅱ组)和对照组(Ⅲ组),各40例。均在全麻下完成手术,Ⅰ、Ⅱ组分别在麻醉诱导前10min、术毕缝皮时静脉注射帕瑞昔布钠40mg,Ⅲ组不使用帕瑞昔布钠;术毕均行患者静脉自控镇痛。监测各组在术后2、6、12、24、48h时疼痛视觉模拟评分(VAS评分)与术后48h内镇痛泵按压次数及不良反应发生情况。结果:与Ⅲ组比较,Ⅰ、Ⅱ组术后6、12、24、48h时VAS评分低(P<0.05),术后48h内镇痛泵按压次数少(P<0.05),术后6、12h时Ⅰ组VAS评分低于Ⅱ组(P<0.05);与Ⅲ组比较,Ⅰ组寒战发生率低(P<0.05)。结论:帕瑞昔布钠用于椎间盘髓核摘除术患者镇痛效果良好,降低了患者自控镇痛泵按压频次,减少了不良反应,术前应用较术后应用效果更好。OBJECTIVE： To observe the effects and safety of postoperative anaesthesia of sodium parecoxib in patients with lumbar intercalated nuclear surgery. METHODS： 120 patients undergoing lumbar intercalated nuclear surgery were randomly divid- ed into parecoxib pre-operation group （group Ⅰ） and parecoxib post-operation group （group Ⅱ ） and control group （group Ⅲ ） with 40 cases in each group. All patients underwent operation with general anaesthesia. Group Ⅰ and Ⅱ were given sodium parecoxib 40 mg intravenously 10 min before induction and during skin suture after operation respectively, while group Ⅲ was not given sodi- um parecoxib; at the end of operation, all patients received intravenous controlled analgesia. The pain scores were evaluated by VAS score at 2, 6, 12, 24, 48 h after operation. The adverse drug reaction and the number of patient-controlling analgesia infusion pump presses within 48 h after the surgery were recorded and compared. RESULTS： Compared with group Ⅲ, VAS score at 6, 12, 24, 48 h after operation of group Ⅰ and Ⅱ was in low level （P〈0.05）, and the number of analgesia infusion pump presses at 48 h after operation reduced （P〈0.05）. VAS scores of group Ⅰ at 6, 12 h after surgery were significantly lower than those of group Ⅱ afte surgery（P〈0.05）. Compared with group Ⅲ, the incidence of trembling of group Ⅰ was in low level （P〈0.05）. CON- CLUSION： Sodium parecoxib has a well postoperative analgesic effect for patients with lumbar intercalated nuclear surgery. It de- creases the frequency of patient-controlling analgesia infusion pump presses, and reduces percentage of adverse drug reaction. Pre-operative application of sodium parecoxib is more effective that post-operative application of it.

关 键 词：帕瑞昔布 椎间盘髓核摘除术 术后镇痛 超前镇痛 

分 类 号：R681.53[医药卫生—骨科学] R971.1[医药卫生—外科学]