预注帕瑞昔布对臂丛神经阻滞的影响  

Effect of pretreatment with parecoxib on brachial plexus block

作　　者：罗高平[1] 胡锦涛[1] 鲍磊[1] 肖凯[1] 彭晓红[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院麻醉科,湖北武汉430033

出　　处：《中国医院药学杂志》2014年第7期580-583,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:观察预注帕瑞昔布对臂丛神经阻滞的影响。方法:80例前臂手术患者随机分为帕瑞昔布组(P组)和对照组(C组),每组40例。2组患者于臂丛阻滞前15min静脉注射帕瑞昔布钠40mg(P组)或5ml生理盐水(C组),观察并记录注射帕瑞昔布钠前(T0),臂丛穿刺前(T1)、穿刺完成后1min(T2)、5min(T3)、30min(T4)以及出手术室之前(T5)的平均动脉压(MAP)、心率(HR)及脉搏氧饱和度(SpO2)、麻醉起效时间、麻醉持续时间、麻醉穿刺时的Ramsay评分及麻醉满意度评分和不良反应情况。结果:2组患者在T2、T3和T4时的MAP比T0时明显升高(P<0.05),2组患者在T2和T3时的HR比T0时明显升高(P<0.05)。P组在T1时的MAP及HR比T0时显著降低(P<0.05);P组患者在T1时的MAP和HR比C组时的各值明显降低(P<0.05);2组患者臂丛神经完全阻滞;P组患者的麻醉起效时间短于C组,Ramsay评分和麻醉满意度评分高于C组,差异有显著性意义(P<0.05),2组的麻醉恢复时间及SpO2均没有显著性差异(P>0.05),未记录到不良反应。结论:臂丛阻滞前预注帕瑞昔布能够减轻穿刺时的血流动力学变化,提高Ramsay评分,增加穿刺时的舒适感和满意度,并且能缩短左布比卡因的起效时间。OBJECTIVE To observe the effect of pretreatment with parecoxib on braehial plexus block, lVlETItODS 80 cases undertaken forearm operation were randomly divided into parecoxib group （group P） and control group （group C）, each group of 40 cases. Patients in two groups received iniection of either parecoxib 40mg （group P） or normal saline 5mL（group C） be- fore 15rain brachial plexus block. The mean arterial pressure （MAP）, heart rate （HR） and pulse oxygen saturation （Spo2） were recorded at different time points： before the injection of parecoxib （T0）, before the brachial plexus puncture （T1）, 1 min （T2）, 5 min （T3）, 30 min （T4） after the completion of puncture and before leaving operation room （T5）. The onset time and duration of block, Ramsay scores while anesthesia puncture, anesthesia satisfaction scores and adverse reactions were ob- served. RESULTS MAP of the two groups at T2, T3 and T4 was significantly higher than To （P〈0. 05）, while the MAP of group P at T1 was significantly lower than the To （P〈0. 05） ; HR of the two groups at T2, T3 was significantly higher than To （P〈0. 05）, while the HR of group P at T1 was significantly lower than the T0 （P〈0. 05） ; MAP and HR of group P were sig- nificantly lower than group C at T1 （P〈0. 05） . the onset time of anesthesia in group P was shorter than it in the group C, the Ramsay score and the anesthesia satisfaction scores were higher than those in group C, there were significant differences （P〈 0. 05） ; Recovery time did not show significantly difference between the two groups after anesthesia, there was no noted adverse medication effects. CONCLUSION Pretreatment with parecoxib can reduce the hemodynamic changes during anesthesia punc- ture, increase the Ramsay score, improve the puncture comfort and satisfaction, and can shorten the onset time of levobupivacain.

关 键 词：帕瑞昔布 臂丛 左布比卡因 

分 类 号：R969[医药卫生—药理学]