帕瑞昔布钠在老年胃癌根治术围术期多模式镇痛中的应用  

Application of parecoxib in perioperative multimodal analgesia in the elder patients with gastric cancer undergoing radical gastrectomy

作　　者：陈伟[1] 李卫[1] 谢东武[1] 饶清 王健[1] 

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《实用医院临床杂志》2014年第2期52-55,共4页Practical Journal of Clinical Medicine

基　　金：绵阳市卫生局科研基金资助项目(编号:201119)

摘　　要：目的观察帕瑞昔布钠在老年胃癌根治术围术期多模式镇痛中的临床应用效果。方法 40例拟行胃癌根治术的患者采用随机数字表法分为多模式镇痛组(M组)和单纯术后镇痛组(P组)各20例。前者采用帕瑞昔布钠超前镇痛联合舒芬太尼患者自控镇痛(PCA),后者仅采用舒芬太尼患者自控镇痛。观察两组患者手术后48 h内在平静、咳嗽及体动时的VAS评分,记录两组患者术后48 h内PCA总次数、有效按压次数及舒芬太尼用量,并观察记录两组患者相关不良反应。结果 M组术后8、12及24 h在平静、咳嗽及体动时VAS评分均显著低于P组(P<0.05),48 h内PCA总次数、有效按压次数及舒芬太尼用量均明显少于P组(P<0.05),恶心及呕吐的发生率明显低于P组(P<0.05)。结论帕瑞昔布钠可安全用于老年胃癌根治术围术期多模式镇痛,可节省舒芬太尼用量,并获得良好的镇痛效果。Objective To observe the clinical effect of parecoxib on perioperative muhimodal analgesia in the elderly patients with gastric cancer who were undergone radical gastrectomy. Methods Forty ASA I - II grade patients undergoing radical gastrecto- my were randomly divided into multimodal analgesia group（ Group M, n = 20）and postoperative analgesia group （Group P, n = 20）. Patients in the group M received preemptive analgesia with parecoxib and patient-controlled analgesia with sufentanil. Patients in the group P received patient-controlled analgesia with sufentanil only. The VAS scores of rest, cough and movement were evaluated during 48 hours. The PCA press times, effective press times and consumption of sufentanil were calculated during the 48 hours. The side-effect during analgesia period was recorded. Results The VAS scores of rest, cough and movement in the group M were significantly lower than that in the group P（P 〈 0.05）. The PCA press times,effective press times and the consumption of sufentanil in the group M were significantly less than that in the group P（P 〈0. 05）. The incidence of nausea and vomiting in the group M were lower than that in the group P（P 〈 0.05 ）. Conclusion The perioperative multimodal analgesia with parecoxib can provide more effective analgesia for the elderly undergoing radical gastrectomy than routine postoperative analgesia do.

关 键 词：多模式镇痛 老年人 帕瑞昔布钠 胃癌 

分 类 号：R614.2[医药卫生—麻醉学] R656.61[医药卫生—外科学]