帕瑞昔布钠联合阿片类镇痛药和B超引导椎旁神经阻滞对于非心脏手术开胸术后镇痛效果评价  

Evaluation of the Analgesic Effect of Parecoxib Sodium Combined with Opioid Analgesics and Ultrasound-guided Paravertebral Nerve Block after Non-cardiac Thoracic Surgery

作　　者：张毅[1] 张琴[1] Nguz A.Kutshid 游艳艳[1] 向桂芳[1] 梅伟[1] 田玉科[1] 李新华[1] 刘凌云[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉430030

出　　处：《华中科技大学学报（医学版）》2013年第4期419-423,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：国家自然科学基金资助项目(No.81100864);国家临床重点专科建设项目[卫办医政函(2012)983号];贝朗麻醉科学研究基金资助项目(No.BBF2010003)

摘　　要：目的评估帕瑞昔布钠分别联合阿片类药物和B超引导的椎旁神经阻滞(PVB)对非心脏手术开胸术后患者的镇痛效果。方法将120名患者(ASA,Ⅰ～Ⅲ级)随机分为4组,每组30例:A组,患者自控镇痛(PCA);B组,PCA+帕瑞昔布钠;C组,PCA+超声引导下PVB;D组,PCA+帕瑞昔布钠+超声引导下的PVB。观察术后阿片类药物的用量、疼痛强度(VAS评分)、不良反应和患者的镇痛满意度。结果 D组的患者镇痛效果最好,镇痛满意度最高并且其阿片类药物的用量最少(均P<0.05)。结论联合使用帕瑞昔布钠、超声引导的PVB和阿片类药物的PCA可以显著改善非心脏开胸手术患者的术后疼痛。Objective To evaluate the efficacy and side effects of combined use of patient-controlled analgesia（PCA）with morphine,parecoxib sodium and ultrasound-guided paravertebral nerve blocks（PVB）for postoperative pain after non-cardiac thoracic surgery.Methods A total of 120patients,with the American Society of Anesthesiology physical statusⅠ—Ⅲ,were enrolled in this study and would undergo non-cardiac thoracic surgery.These patients were divided into 4groups randomly： group A（30patients who received PCA）,group B（30patients who received parecoxib sodium and PCA）,group C（30patients who received PCA and ultrasound-guided PVB）,group D（30patients who received parecoxib sodium,PCA and ultrasoundguided PVB combined）.The total dose of opioid analgesics,VAS scores,side effects,and patient satisfaction were obtained and compared among the groups.Results Patients who received parecoxib sodium,PCA and ultrasound-guided PVB combined experienced significantly greatest maximum pain relief and highest satisfaction than those in other groups.Conclusion Combination of parecoxib sodium,ultrasound-guided PVB and PCA with opioid analgesics significantly improves postoperative analgesic effects as evidenced by reduction in opioid usage,lower pain scores and higher patient satisfaction.

关 键 词：椎旁神经阻滞 超声引导 帕瑞昔布钠 开胸术后镇痛 患者自控镇痛 

分 类 号：R971[医药卫生—药品]