帕瑞昔布钠预防硬腰联合麻醉下前列腺电切术患者寒战的临床观察  

Clinical observation of parecoxib sodium on prevention of shiver in patients after transurethral resection of prostate under combined spinal epidural analgesia

作　　者：肖和平 

机构地区：[1]衡东县人民医院麻醉科,湖南衡东421421

出　　处：《现代医药卫生》2013年第5期660-661,共2页Journal of Modern Medicine & Health

摘　　要：目的比较帕瑞昔布钠和曲马多预防硬腰联合麻醉下前列腺电切术患者寒战的临床效果。方法将60例在硬腰联合麻醉下接受前列腺电切术的患者随机分为三组,P组、T组和C组,各20例,分别于麻醉前15 min,静脉注射帕瑞昔布钠40 mg、曲马多1～2 mg/kg和等容生理盐水。观察硬腰联合麻醉后有无寒战发生及程度、镇静评分和不良反应等。结果三组患者年龄、身高、体质量、手术时间比较,差异无统计学意义(P>0.05);与T组、P组比较,C组寒战发生率高,且C组患者寒战评分较高,差异有统计学意义(P<0.05)。与T组比较,P组寒战发生率降低,差异有统计学意义(P<0.05);P组Ramasy评分为2～4级的患者比率大于T组,而T组Ramasy评分为5～6级的患者比率大于P组,差异有统计学意义(P<0.05);T组有5例患者发生不同程度的恶心、呕吐,P组无一例出现,舒适度增加。结论麻醉前静脉注射帕瑞昔布钠,可有效预防硬腰联合麻醉下前列腺电切术中患者寒战的发生。Objective To compare the clinical effects of parecoxib sodium and tramadol on the prevention of shiver in the patients after transurethral resection of prosrate （TURP） under combined spinal epidural analgesia. Methods 60 patients undergoing TURP under combined spinal epidural analgesia were randomly divided into the group P, T and C, 20 cases in each group. All cases received combined spinal epidural analgesia. Before agalgesia, the group P was intravenously injected by pare- eoxib sodium 40 mg,the group T by tramadol 1-2 mg/kg and the group C by isometric normal saline. To observe and record the incidence rate of shiver, Ramesay sedation scores （RSS） and adverse reactions in three groups. Results The difference of age, height, weight and operation time among these three groups had no statistical significance （P〉0.05）. The occurrence rate of shiver in the group C was significantly higher than that in the group T and P, and the shiver score in the group C was highest, the differ- ence showing statistical significance （P〈0.05）. Compared with the group T, the incidence rate of shiver in the group P was de- creased with statistical difference （P〈0.05）. The proportion of the patients with RSS 2-4 level in the group P was higher than that in the group T, but the proportion of the patients with RSS 5-6 level in the group T was higher than that in the group P with statisti- cal significance in difference （P〈0.05）. 5 cases in the group T had nausea and vomiting,while no case of nausea and vomiting appeared in the group P. Conclusion Intravenous parecoxib sodium before anesthesia can effectively prevent the occurrence of shiver in the patients after TURP under combind spinal epidural analgesia.

关 键 词：曲马朵 寒战 麻醉 副作用 电外科手术 前列腺切除术 帕瑞昔布钠 

分 类 号：R473.5[医药卫生—护理学]