帕瑞昔布钠用于腹腔镜胆囊切除术多模式镇痛的疗效分析  

Effect analysis of multimode analgesia of parecoxib sodium during laparoscopic cholecystectomy

作　　者：毕仁兵[1] 暨玲[2] 王小坤[1] 

机构地区：[1]湖北省荆门市第一人民医院普外Ⅲ科,448000 [2]温州医学院附属第一医院腔镜外科

出　　处：《中华医学杂志》2013年第34期2727-2729,共3页National Medical Journal of China

摘　　要：目的探讨帕瑞昔布钠用于多模式镇痛对腹腔镜胆囊切除术后疼痛的影响。方法采用前瞻、双盲、随机、对照研究的方法，选择于2011年3至6月在温州医学院附属第一医院腔镜外科择期行腹腔镜胆囊切除术患者80例，随机均分为两组，试验组术前30rain静脉注射帕瑞昔布钠40mg，术后12、24、36、48h分别静脉注射帕瑞昔布钠40mg，对照组于相同时点静脉注射生理盐水各2ml。两组患者均于手术结束时予罗哌卡因局部浸润麻醉手术切口。术后1、2、4、8、12、24、36、48h采用视觉模拟评分法（VAS）评估两组患者疼痛程度，并记录术后24h内哌替啶用量。结果试验组术后各时点VAS评分（1h：1．0±0．6、8h：2．5±1．4、24h：1．6±0．8、48h：1．0±0．5）明显低于对照组（1h：1．8±0．6、8h：5．0±1．8、24h：2．5±1．4、48h：1．5±0．6）（P〈0．01），且术后24h内试验组哌替啶的用量明显少于对照组（P〈0．01）。结论静脉注射帕瑞昔布钠40mg用于多模式镇痛可有效减轻腹腔镜胆囊切除术后疼痛。Objective To explore the effects of parecoxib sodium muhimode analgesia on postoperative analgesia in patients undergoing laparoscopie cholecystectomy （LC）. Methods A prospective, double-blind, randomized and placebo-controlled study was conducted on 80 patients undergoing elective LC at Department of Endoscopic Surgery, First Affiliated Hospital, Wenzhou Medical College from March 2011 to June 2011. They were randomized to receive either 40 mg parecoxib infusion 30 rain preoperative and at 12, 24, 36, 48 h post-operation （ treatment group ） . And 2 ml normal saline infusion was administered similarily as a placebo （ control group）. All patients received ropivacaine infusion at port sites at the end of LC. The degree of postoperative pain was assessed with visual analog scale （VAS） at 1, 2, 4, 8, 12, 24, 36, 48 h post-operation respectively. The consumption of pethidine in the first 24 h post-operation was also recorded. Results The VAS pain scores at each timepoint were significantly lower in the treatment group than those in the control group （1 h： 1.0 ±0.6 vs 1.8 ±0.6,t = -1.650, P= 0.000;2h： 1.3 ±0.6vs 1.9 _±0.7, t= -4.302, P=0.000;4h： 1.6 ±0.7 vs2.7±1.2,t= -4.752, P=0.000;8 h： 2.5 ±_1.4 vs5.0±_1.8, t= -6.835, P=0.000; 12 h： 2.2±1.1 vs 3.3 ±1.5, t= -3.902, P=0.000; 24 h： 1.6±0.8 vs2.5 ±1.4, t= -3.649, P =0.000; 36 h： 1.2 ±0.6 vs 2.2 ± 0.8, t= -6. 390, P=0.000;48 h： 1.0±_0.5 vsl. 5±_0.6, t= -3. 710, P=0.000）. And the amount of pethidine used in the first 24h after LC was also less in the treatment group （150 vs 950 mg, X2 = 16. 200, P =0. 000）. Conclusion The infusion muhimode analgesia of parecoxib sodium 40 mg provides significant effect of postoperative pain relief after laparoseopie eholecystectomy.

关 键 词：胆囊切除术 腹腔镜 镇痛 帕瑞昔布钠 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]