帕瑞昔布钠在老年胃癌根治术围术期超前镇痛中的应用  

Application of Parecoxib on Perioperative Preemptive Analgesia in the Elderly 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]绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《四川医学》2014年第7期793-795,共3页Sichuan Medical Journal

摘　　要：目的：观察帕瑞昔布钠在老年胃癌根治术围术期超前镇痛中临床应用的效果。方法选择 ASAⅠ-Ⅱ级,年龄60～75岁,体重〉50kg,拟行胃癌根治术的患者40例,随机分为超前镇痛组（P 组,n =20）和对照组（C 组,n =20）。前者采用帕瑞昔布钠进行围术期超前镇痛,后者采用舒芬太尼患者自控镇痛。观察两组患者手术后48h 内平静、咳嗽及体动时的 VAS 评分,记录两组患者术后肠鸣音恢复时间、肛门排气时间及胃管保留时间,并观察记录两组患者相关不良反应。结果 P 组患者在术后24及48h 平静、咳嗽及体动时 VAS 评分均显著低于 C 组患者（P 〈0.05）,P 组患者术后肠鸣音恢复时间和肛门排气时间显著短于 C 组患者（P 〈0.05）,P 组患者恶心及呕吐的发生率明显低于 C 组患者（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超前镇痛,镇痛效果确切,并利于患者胃肠功能恢复。Objective To observe the clinical effect of parecoxib on perioperative preemptive analgesia in the elderly undergoing radical gastrectomy. Methods Forty ASA Ⅰ ～ Ⅱ grade patients undergoing radical gastrectomy, aged 60 ～ 75 years, body weight more than 50kg, were randomly divided into preemptive analgesia group （Group P, n = 20） and control group （Group C, n = 20）. The patients in group P received preemptive analgesia with parecoxib. The patients in group C received patient-con-trolled analgesia with sufentanil. The VAS scores of rest, cough and movement were evaluated during 48 hours. The intestinal sounds recovery time, the anal exsufflation time and gastric tube indwelling time were recorded. The side-effect during analgesia period were observed. Results The VAS scores of rest, cough and movement in group P were significantly lower than that in group C （P 〈 0. 05）. The intestinal sounds recovery time and the anal exsufflation time in group P were significantly less than that in group C （P 〈 0. 05）. The incidence of nausea and vomiting in group P were lower than that in group C （P 〈 0. 05）. Conclusion The perioperative preemptive analgesia with parecoxib can provide more effective analgesia for the elderly undergoing radical gastrectomy than routine postoperative analgesia.

关 键 词：超前镇痛 老年人 帕瑞昔布钠 胃癌 

分 类 号：R735.2[医药卫生—肿瘤]