帕瑞昔布钠超前应用减轻异丙酚注射痛  

Effect of Parecoxib Preapplication on Propofol Injection Pain

作　　者：钟和英[1] 冉然[1] 田刚[1] 李颖波[1] 余开峰[1] 

机构地区：[1]湖北医药学院附属人民医院麻醉科,湖北十堰442000

出　　处：《现代生物医学进展》2013年第13期2525-2527,共3页Progress in Modern Biomedicine

基　　金：2012年十堰市科学技术研究与开发项目计划(078S)

摘　　要：目的：比较注射不同剂量帕瑞昔布钠预防异丙酚注射痛的效果。方法：采用随机双肓对照方法,选择我院择期手术病人150例,ASA I~Ⅱ级,随机分为3组,每组50例。麻醉诱导前1 min,均从手背静脉预给药,给药前使该手臂举起15 sec,然后在前臂近端扎止血带放平。A组：静脉注射帕瑞昔布钠40 mg;B组：静脉注射帕瑞昔布钠20 mg;均溶于5 mL生理盐水;C组：静脉注射0.9%生理盐水5 mL。推注60 sec后松开止血带,以0.5 ml/sec的速度注射异丙酚。注射期间使用4分法对注射痛评分。结果：与B组和C组比较,A组异丙酚注射痛发生率明显降低（P〈0.001）。三组患者异丙酚注射痛的VRS评分在轻度疼痛方面没有差异。但在中至重度疼痛方面A组和B组明显低于C组（P〈0.001）。A组的无痛患者明显高于B组,而VRS评分明显低于B组（P〈0.001）。结论：静脉注射帕瑞昔布钠40 mg预充盈血管60 sec均能明显降低异丙酚注射痛。静脉注射帕瑞昔布钠20 mg能降低异丙酚注射痛的程度但不能降低异丙酚注射痛的发生率。Objective： To investigate the effect of parecoxib pretreatment with venous occlusion on propofol injection pain.150 ASA physical status I patients were scheduled for elective surgery.Methods： Patients were randomized to three groups of 50 patients each to receive pretreatment with parecoxib 40 mg（Group A）,parecoxib 20 mg（Group B） or normal saline（Group C）.All groups underwent venous occlusion for one minutes before propofol was injected.All pretreatment drugs were prepared in 5 mL doses.Pain scores were obtained by a study-blinded observer during propofol injection following the different pretreatment solutions.Results： Pain scores among the three groups were significantly different（P ≤0.001）.In Group C,29（58%） patients had pain during propofol injection compared with 22（40%） Group B and 13（26%） Group A patients（P ≤ 0.005）.Pain was significantly reduced in Group A（P ≤ 0.001） compared with the control group.Moderate to severe pain was experienced by 18（36%） Group C and 4（8%） Group B patients,whereas no Group C patient experienced moderate or severe pain（P0.001）.Reduction in pain severity was statistically significant after pretreatment with either parecoxib 20 mg（P = 0.002） or parecoxib 40 mg（P 0.001）.Conclusion： Parecoxib 40 mg with venous occlusion is effective in reducing the frequency and severity of pain with propofol injection.Pretreatment with 20 mg of parecoxib reduces the severity of propofol injection pain significantly but does not reduce frequency compared with the control group.

关 键 词：异丙酚 帕瑞昔布钠 注射痛 超前应用 

分 类 号：R614[医药卫生—麻醉学]