帕瑞昔布超前镇痛对老年髋关节置换术患者应激反应的影响  

Influence of parecoxib preemptive analgesia on stress responses in the elderly undergoing total hip replacement

作　　者：缪建中[1] 何之学[1] 温来友[1] 

机构地区：[1]东南大学医学院附属江阴医院麻醉科,江苏省214400

出　　处：《江苏医药》2013年第21期2590-2591,共2页Jiangsu Medical Journal

摘　　要：目的观察帕瑞昔布超前镇痛对行全髋关节置换术(THR)的老年患者应激反应的影响。方法在腰-硬联合麻醉下行THR的老年患者84例随机均分为两组:A组于麻醉前30min和术后12h分别肌肉注射帕瑞昔布40mg;B组用生理生理盐水作为对照。术后均行舒芬太尼自控静脉镇痛。于麻醉前、手术结束、术后12h和24h记录BP和HR,测定血糖(BG)、血浆皮质醇(Cor)和去甲肾上腺素(NE)。结果术后A组BP明显低于B组(P<0.05)。术后12h和24h,两组血浆Cor和NE均较术前明显升高(P<0.05),但A明显低于B组(P<0.05)。结论帕瑞昔布钠超前镇痛能有效减轻THR老年患者应激反应。Objective To observe the influence of parecoxib preemptive analgesia on stress responses in the elderly undergoing total hip replacement（THR）. Methods THR was performed in 84 cases aged 65-78 years old under spinal-epidural combined anesthesia, who were equally assigned into two groups of A（injected parecoxib 40 mg at 30 min before anesthesia and 40 mg at 12 h after operation） and B （injected normal saline as the control）. The postoperative patient-controlled intravenous analgesia with sufentanil was given in two groups. The BP, HR, blood glucose（BG）, cortisol（Cor） and norepinephrine（NE） were measured before anesthesia, at the end of operation, 12 h and 24 h after operation. Results The BP after operation was lower in group A than that in group B （P〈0. 05）. Plasma levels of Cor and NE in both groups were hight at 12 h and 24 h after operation than those before anesthesia （P〈0. 05 ）, which were lower in group A than those in group B （P〈0. 05）. Conclusion Parecoxib injection is effective in attenuating the stress responses in the elderly undergoing THR.

关 键 词：帕瑞昔布 镇痛 应激反应 老年 

分 类 号：R614[医药卫生—麻醉学]