三种镇痛方案用于腰椎内固定术后镇痛的效果比较  

COMPARISON OF THE EFFECTS OF THREE ANALGESIC PROTOCOLS AFTER INTERNAL FIXATION OF THE LUMBAR SPINE

作　　者：何卓文[1] 李么琴[1] 曾晓萍[1] 

机构地区：[1]肇庆市第一人民医院,广东肇庆526000

出　　处：《现代医院》2014年第3期23-25,共3页Modern Hospitals

摘　　要：目的比较帕瑞昔布钠和地佐辛三种不同配伍方案用于腰椎内固定术后镇痛的效果。方法将120例需行腰椎内固定术的患者随机分三组:地佐辛-地佐辛组(Ⅰ组)、帕瑞昔布钠-帕瑞昔布钠组(Ⅱ组)和帕瑞昔布钠-地佐辛组(Ⅲ组),各40例。分别于按预案实行术后镇痛。观察并记录每位患者复苏的情况及苏醒后、6、12、24、48 h各时间点的VAS镇痛评分和Ramsay镇静评分,术后镇痛期间的不良反应等。结果Ⅰ组于术后的镇痛镇静最强,拔管耗时最长,镇痛并发症较多;Ⅱ组的术后镇痛效果最差,术后发生躁动和需追加镇痛药的病例最多;Ⅲ组术后镇痛评分与Ⅰ组相当(p>0.05),但镇静评分明显低于Ⅰ组(p<0.05),不良反应相对较少。结论帕瑞昔布钠联合地佐辛于腰椎内固定术后镇痛效果显著,值得推介。Objective To compare the analgesic effects of parecoxib sodium and dezocine in three different protocols for patients after internal fixation of the lumbar spine. Methods A total of 120 patients requiring internal fixation of the lumbar spine were randomly divided into three groups ： dezocine - dezocine group （ group Ⅰ ）, parecoxib sodium - parecoxib sodium group （group Ⅱ ） and parecoxib sodium - dezocine group （ group Ⅲ ）, 40 cases in each group. Postoperative analgesia was performed according to the protocol. The conditions of every patient after palinesthesia, the VAS scores and Ramsay scores at 6, 12, 24 and 48 h after palinesthesia and the adverse reactions during the postoperative analgesia period were observed and recorded. Results In group Ⅰ , the postoperative analgesia and sedation were most effective, the extubation time was the longest and the analgesic complications were frequent ; in group Ⅱ, the postoperative analgesia was less effective, the number of cases who experienced postoperative restlessness and required additional analgesics was the most; the postoperative analgesia scores in group Ⅲ were comparable to those in group Ⅰ （p 〉 0. 05）. However, the sedation scores in group Ⅲ were significantly lower than those in group Ⅰ （p 〈 0. 05）, with fewer adverse reactions. Conclusion Parecoxib sodium combined with dezocine has significant postoperative analgesic effect in internal fixation of the lumbar spine, and is worthy of popularization.

关 键 词：地佐辛 帕瑞昔布钠 腰椎内固定术 镇痛 

分 类 号：R971.2[医药卫生—药品]