帕瑞昔布钠术前镇痛对直肠癌根治术后芬太尼用量的影响  

Effect of pre-operative parecoxib sodium on the dosage of fentanyl used after radical resection of rectal carcinoma

作　　者：何旭秀 

机构地区：[1]青海省中医院麻醉科,西宁810000

出　　处：《中国新药杂志》2015年第3期308-311,共4页Chinese Journal of New Drugs

摘　　要：目的：观察帕瑞昔布钠术前镇痛对直肠癌根治术患者术后芬太尼用量的影响。方法：选择2013年1月至2014年6月我院肛肠科择期在全麻下行开腹直肠癌根治术的患者90例，ASAI～Ⅱ级，年龄50～75岁，采用随机表法分为3组，每组30例。A组于手术切皮前30min静脉注射帕瑞昔布钠40mg（溶于4mL0．9％氯化钠溶液），B组手术结束前30min静脉注射帕瑞昔布钠40mg，C组手术切皮前30min注射生理盐水4mL。术后均采用静脉芬太尼PCIA。观察并记录术后2，6，12，24，48hVAS和Ramsay评分，记录术后48h芬太尼总用量及术后恶心、呕吐、头晕和呼吸抑制情况。结果：与C组比较，术后2，6，12h，A组和B组VAS评分和Ramsay评分明显降低（P〈0．05），与A组比较，B组和C组术后镇痛芬太尼总用量明显增加（P〈0．05），术后恶心、呕吐、头晕发生率明显升高（P〈0．05），3组无一例呼吸抑制。结论：①帕瑞昔布钠40mg静脉注射对直肠癌根治术患者的术后疼痛有较好的镇痛效果，能有效减少直肠癌根治术患者术后PCIA芬太尼用量。②相对于手术结束前给药，手术开始前即给予帕瑞昔布钠更能充分发挥其临床镇痛效果，降低不良反应发生率。Objective： To observe the influence of pre-operative parecoxib sodium on the dosage of fentanyl used after radical resection of rectal carcinoma. Methods ： Totally 90 patients undergoing radical resection of rectal carcinoma under general anesthesia were chosen between Jan 2013 to Jun 2014. Patients on ASA I -Ⅱ grade, ages from 50 to 75 years-old, were divided into 3 groups by a random table method （n = 30 for each group）. Parecoxib sodium 40 mg（ dissolved in 4 mL saline） was intravenously injected 30 min before skin incision or 30 min before the end of operation; in control group, 4 mL saline was intravenously injected 30 min before skin incision. Post-opera- tive patient-controlled intravenous analgesia （PCIA） with fentanyl was adopted in all the three groups. VAS and Ramsay scores were observe and recorded 2, 6, 12, 24 and 48 h after the operation. Moreover, the total dosage of fentanyl used, nausea, vomiting, dizziness and respiratory inhibition during 48 h after the operation were also recor- ded. Results： Compared with control group, VAS and Ramsay scores at 2, 6 and 12 h after the operation were sig- nificantly decreased in patients of two parecoxib sodium groups （P 〈 0.05）. Compared with injection of parecoxib sodium at 30 min before skin incision, the total dosage of fentanyl, and the incidence rates of post-operative nause-a, vomiting and dizziness significantly increased （P 〈 0.05） in patients receiving parecoxib sodium at 30 min be- fore the end of operation or saline at 30 min before skin incision. Besides, no respiratory depression occurred in the three groups. Conclusion ： Pre-operative intravenous parecoxib sodium 40 mg potentiates the ana tanyl, relieving any1 used in PC patients＇ pain after radical resection of rectal carcinoma. It can effectively reduce lgesic effect of fen- the dosage of fent- IA of colorectal cancer patients after operation. Administration of parecoxib sodium before operation shows more potent analgesic effects and fewer incidences of adver

关 键 词：帕瑞昔布钠 直肠癌根治术 芬太尼 自控镇痛 

分 类 号：R971.2[医药卫生—药品]