环氧化酶-2抑制剂对老年患者全麻苏醒质量影响的初步评价  

Preliminary evaluation of COX-2 inhibitor's effects on emergence quality from general anesthesia in elderly patients

作　　者：方韬[1] 卢照德[1] 金辉[1] 钱思源[2] 

机构地区：[1]金华市人民医院麻醉科,浙江金华321000 [2]国家食品药品监督管理局药品审评中心,北京100038

出　　处：《中国临床药理学杂志》2013年第6期410-412,422,共4页The Chinese Journal of Clinical Pharmacology

基　　金：浙江省金华市科技局计划基金资助项目(2010-3-068)

摘　　要：目的评价环氧化酶-2(COX-2)抑制剂对老年病人全麻苏醒质量的影响。方法 60例65～80岁男性全麻患者,随机分为帕瑞昔布组和哌替啶组,每组30例。2组病人在手术结束前30 min分别静脉注射帕瑞昔布40 mg或哌替啶50 mg,记录患者苏醒期间血压、心率等生命体征,及苏醒时间、拔管时间、镇痛程度、清醒程度、躁动及导尿管刺激反应等。结果拔管时2组患者的心率、血压均较术前基础值明显增高;帕瑞昔布组心率、血压增高的程度均低于哌替啶组。哌替啶组的苏醒时间和拔管时间较帕瑞昔布组明显延长(P<0.05);达到3级以上清醒程度者远低于帕瑞昔布组(P<0.05)。帕瑞昔布组患者镇痛效果较好,躁动率和镇痛不全的人数低于哌替啶组(P<0.05),导尿管刺激反应明显轻于哌替啶组患者,其轻度反应者(0级加I级)明显多于哌替啶组(P<0.01)。结论帕瑞昔布能提高老年患者全麻苏醒期镇痛效果,抑制导尿管刺激征和苏醒期躁动,稳定血流动力学,改善老年患者的苏醒期质量。Objective To evaluate the effectiveness of COX -2 inhibi- tor on recovery quality in elderly patients undergoing general anesthesia. Methods A total of 60 elderly male patients received general anesthesia were randomly divided into parecoxib group （n = 30 ） and meperidine group （ n = 30）. At 30 minutes before the end of surgery, patients of two groups were intravenously injected with 40 mg parecoxib or 50 mg meper- idine respectively. Blood pressure （BP）, heart rate （HR）, awakening time, extubation time, analgesic effect, consciousness degree （CD）, emergence agitation （EA） and catheter- related bladder discomfort （CRBD） were recorded during recovery period. Results BP and HR of all patients when extubation increased obviously in contrast to preopera- tive, but patients in parecoxib group increased more mildly than meperi- dine group. Awakening and extubation time of pareeoxib group were pro- longed obviously than meperidine group（P 〈0.05）. The CD were better in group parecoxib group with more patients above degree 3 than that of meperidine group （ P 〈 0. 05 ）. On the contrary, analgesic effect of pareeoxib sodium was better. There were much less EA and incomplete analge- sia （IA） in pareeoxib group than in meperidine group （ P 〈 0. 05 ）. And the CRBD were much milder with more patients of degree 0 and 1 in parecoxib group than meperidine group （ P 〈 0. 01 ）. Conclusion Parecoxib intravenous injection can effectively improve the quality of emergence and analgesia effect, and inhibiting CRBD and EA, and more stable hemodynamic during recovery period in elderly patients.

关 键 词：帕瑞昔布 老年患者 苏醒期质量 全身麻醉 

分 类 号：R971.1[医药卫生—药品] R614.2[医药卫生—药学]