帕瑞昔布钠与氟比洛芬酯对重症肌无力患者的术后镇痛效果比较  

Comparison of the postoperative analgesic effects of parecoxib sodium and flurbiprofen axetil on patients with myasthenia gravis

作　　者：黄龙[1] 林世清[2] 周雪[2] 

机构地区：[1]广东省深圳市第五人民医院麻醉科,518000 [2]中山大学附属第一医院麻醉科,广州市510080

出　　处：《实用医学杂志》2013年第8期1335-1337,共3页The Journal of Practical Medicine

摘　　要：目的:比较帕瑞昔布钠与氟比洛芬酯对重症肌无力患者的术后镇痛效果。方法:行扩大范围胸腺切除术的患者150例,随机分为3组:A组(n=50)为帕瑞昔布钠组,于切皮前20min(T1)缓慢静注帕瑞昔布钠40mg,手术结束时(T2)再静注40mg;B组(n=50)为氟比洛芬酯组,于T1时缓慢静注氟比洛芬酯50mg,在T2时再静注50mg;C组为对照组(n=50),不给任何镇痛药。记录术后1、2、6、12及24h的静息和运动VAS评分及患者的心率、血压、动脉血氧饱和度情况,记录术后24h的胸片结果及术后不良反应。结果:与C组比较,A组和B组在术后各时点的静息和运动VAS评分均显著降低(P<0.01);A组术后6、12及24h的运动VAS评分显著低于B组(P<0.05)。C组患者在术后各时点的心率和血压均明显高于同时点A组和B组的水平(P<0.05)。3组患者术后均无呼吸困难及肌无力危象发生,恶心、呕吐发生率A组出现3例,B组为8例,C组5例;C组出现4例轻度肺不张。结论:帕瑞昔布钠与氟比洛芬酯用于重症肌无力患者术后镇痛均有良好的镇痛效果,前者的镇痛时间更长且不良反应更少。Objective To compare the postoperative analgesic effects of parecoxib sodium and flurbiprofen axetil on patients with myasthenia gravis. Methods 150 patients who, received extended range thymectomy, were randomly divided into 3 groups ： those in Group A （n = 50） received intravenous injection of 40mg of parecoxib sodium at 20 mins before skin incision （T1） and at the end of surgery （T2） ; those in Group B （n = 50） received intravenous injection of 50 mg of flurbiprofen at T1 and T2; and those in Group C （n = 50） received no analgesic as the control group. The resting and moving VAS scores as well as the patients＇ heart rate, blood pressure, arterial oxygen saturation at 1 h, 2 h, 6 h, 12 h and 24 h after operation were recorded. The chest X-ray results and adverse reactions at 24 h after operation were also recorded. Results Compared with those in Group C, the resting and moving VAS scores, heart rate and blood pressure at all time points were lower in Group A and B （P 〈 0.01 or P 〈 0.05）. The moving VAS scores at 6 h, 12 h and 24 h after operation in Group A were lower than those in Group B （P 〈 0.05）. Breathing difficulties and muscle weakness did not occur in the 3 groups; 3 patients in Group A, 8 patients in Group B and 5 patients in Group C had nausea and vomiting; and 4 patients in Group C had mild atelectasis. Conclusion Parecoxib sodium and flurbiprofen axetil had good postoperative analgesic effects in patients with myasthenia gravis and the former had longer analgesic time with fewer adverse reactions.

关 键 词：重症肌无力 帕瑞昔布钠 氟比洛芬酯 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]