帕瑞昔布钠超前镇痛对开胸患者术后自控镇痛效果的影响  

Effect of Preemptive Analgesia with Parecoxib on Postoperative Patient-controlled Analgesia in Patients Undergoing Thoracotomy

作　　者：刘文贵[1] 陈剑[1] 刘江洪[1] 刘培斌[1] 刘才堂[1] 

机构地区：[1]中山大学附属东华医院麻醉科,广东东莞523110

出　　处：《实用临床医学（江西）》2013年第1期35-37,共3页Practical Clinical Medicine

摘　　要：目的观察帕瑞昔布钠超前镇痛对胸腔镜辅助开胸术后静脉自控镇痛(PCIA)效果的影响。方法将60例ASAⅠ—Ⅱ级择期行胸腔镜辅助开胸术患者按随机数字表法分为3组:超前镇痛组(A组)20例于手术切皮前30 min静脉注射帕瑞昔布钠40 mg;常规镇痛组(B组)20例于手术缝皮时静脉注射帕瑞昔布钠40 mg;对照组(C组)20例不给予帕瑞昔布钠。3组患者术后均行曲马多静脉自控镇痛。分别记录术后1、2、4、8、12、24 h的视觉模拟评分(VAS),记录术后24 h内镇痛泵按压次数、有效按压次数、曲马多的用量及其不良反应发生率。结果与C组比较,A组和B组术后1、2、4、8、12 h VAS评分,术后24 h内镇痛泵按压次数、有效按压次数,曲马多的用量及不良反应发生率均显著降低(P<0.05)。与B组比较,A组术后1、2、4、8、12 h VAS评分,术后24 h内镇痛泵按压次数、有效按压次数,曲马多的用量及不良反应发生率均显著降低(P<0.05)。结论帕瑞昔布钠于胸腔镜辅助开胸术超前运用,能减少术后PCIA曲马多用量,减轻不良反应的发生并提高镇痛效果。Objective To observe the effect of preemptive analgesia with parecoxib on patient-controlled intravenous analgesia（PCIA）after thoracoscopic thoracotomy.Methods Sixty ASA Ⅰ-Ⅱ patients undergoing selective thoracoscopic thoracotomy were randomly divided into three groups,with 20 patients in each group.Preemptive analgesia group（group A）and conventional analgesia group（group B） were given intravenous injection of 40 mg parecoxib at 30 minutes before skin incision and at skin closure,respectively.The control group（group C）was not given parecoxib.All patients received PCIA with tramadol after surgery.Postoperative analgesia efficacy was assessed by visual analog scales（VAS） at 1,2,4,8,12 and 24 hours after surgery.The analgesia pump button pressing times,effective pressing times,amount of tramadol,and incidence of adverse reactions were recorded within 24 hours after surgery.Results Compared with group B,VAS,analgesia pump button pressing times,effective pressing times,amount of tramadol and incidence of adverse reactions significantly increased in group C but obviously decreased in group A（all P0.05）.Conclusion Preemptive analgesia with parecoxib for thoracoscopic thoracotomy can reduce the amount of tramadol,decrease the incidence of adverse reactions and improve the analgesic efficacy.

关 键 词：帕瑞昔布钠 超前镇痛 环氧化酶-2抑制剂 开胸术 自控镇痛 

分 类 号：R614[医药卫生—麻醉学]