地佐辛联合帕瑞昔布钠超前镇痛对直肠癌术后镇痛效果观察  

Preemptive Analgesic Effects of Dezocine Joint Parecoxib Sodium for Postoperative Analgesia in Colorectal Cancer

作　　者：邹明[1] 姜万维[1] 王庆辉[1] 李禹[1] 许民[1] 段海霞[1] 于学美[1] 

机构地区：[1]大连大学附属中山医院麻醉二部,辽宁大连116021

出　　处：《中国肛肠病杂志》2014年第11期22-24,共3页Chinese Journal of Coloproctology

摘　　要：为探讨地佐辛与帕瑞昔布钠联合应用能否有效提高超前镇痛的效果及减少其它阿片类镇痛药物的用量，减轻直肠癌患者术后的疼痛及不良反应，将行直肠癌根治术的患者120例随机分为3组，每组40例。第一组（P组）：手术结束前30min静脉注射帕瑞昔布钠40mg；第二组（D组）：手术结束前30min静脉注射地佐辛5mg；第三组（PD组）：手术结束前30min静脉注射帕瑞昔布钠40mg和地佐辛5mg，术后所有患者行静脉自控镇痛（PCA）治疗。观察患者术后疼痛视觉模拟评分（VAS），PCA有效按压次数和首次肛门排气、排便时间，Ramsay镇静评分，恶心、呕吐发生率等指标。结果显示，PD组患者PCA有效按压次数显著少于P组和D组（P〈O．05）；PD组患者首次肛门排气、排便时间早于P组和D组（P〈0．05）。结果表明，直肠癌根治术采用地佐辛联合帕瑞昔布钠超前镇痛加PCA治疗效果明确，可降低枸橼酸芬太尼的用量，患者胃肠功能恢复快。This paper was to discuss preemptive analgesic effects of dezocine joint parecoxib sodium and reduce the dose of other opioid analgesic drugs,so as to reduce postoperative pain and adverse reactions.The 120 cases of colorectal cancer undergoing radical surgery were randomly divided into three groups 40 cases for each group.Group ] （group P）received intravenous injection of parecoxib sodium 40mg 30min before the end of surgery,group H （group D） received intravenous injection of dezocine 5 mg,group Ⅲ （group PD） received intravenous injection of parecoxib sodium 40mg and dezocine 5 rag.All groups underwent patient controlled analgesia（PCA） postoperatively,and observed for VAS,the effective pressing frequency of PCA and the time to first flatus and defecation,Ramsay sedation score, nausea, vomiting and other indicators.The results showed that the effective pressing frequency of PCA was less in group PD than in the other two groups （ P〈0.05） ; the time to first flatus and defecation was earlier in group PD than in the other two groups （ P 〈0.05）.It is concluded that dezocine joint parecoxib sodium shows potent preemptive analgesic effects in combination with PCA in radical resection of colorectal cancer,and reduces the dose of fentanyl citrate and improve the rapid recovery of gastrointestinal function.

关 键 词：直肠癌 地佐辛 帕瑞昔布钠 超前镇痛 术后镇痛 

分 类 号：R971.2[医药卫生—药品]