帕瑞昔布钠联合罗哌卡因局部浸润用于颈椎前路减压术后镇痛观察  

Efficacy of parecoxib sodium combined with local infiltration anesthesia with ropivacaine for postoperative pain after Anterior cervical decompression

作　　者：桂靖[1] 董巍檑[2] 

机构地区：[1]南华大学附属第二医院麻醉科,湖南衡阳421001 [2]南华大学附属第一医院,湖南衡阳421001

出　　处：《蛇志》2015年第2期130-131,153,共3页Journal of Snake

摘　　要：目的观察帕瑞昔布钠联合罗哌卡因局部浸润用于颈椎前路减压术患者术后镇痛的效果。方法选择拟全麻下行颈椎前路减压术患者60例,随机分为A组(帕瑞昔布钠+1%罗哌卡因组)30例,B组(舒芬太尼组)30例。采用瑞芬太尼和异丙酚双通道靶控输注麻醉。于缝合前即刻,A组静脉注射帕瑞昔布钠40mg,1%罗哌卡因15ml逐层浸润切口周围肌肉、皮下组织和皮肤;B组静脉给予负荷量舒芬太尼4μg(4ml),行自控静脉镇痛。分别记录术后4、8、16、24h(T1、T2、T3、T4)的疼痛、镇静、恶心呕吐评分,疼痛情况用水平视觉模拟评分法(VAS)评估,镇静程度以Ramsay评分法评分。结果两组患者均达到满意的镇痛效果。B组各时点Ramsay评分均高于A组,T2、T3时点比较差异有统计学意义(P<0.05)。但B组T2、T3时点恶心呕吐发生率高于A组,差异具有统计学意义(P<0.05)。结论帕瑞昔布钠联合1%罗哌卡因局部浸润用于颈椎前路减压术后镇痛与舒芬太尼自控静脉镇痛比较,均获得良好的镇痛效果,且不增加患者的镇静水平,减少了恶心呕吐等副作用的发生率。Objective To investigate efficacy of parecoxib sodium combined with local infiltration anesthesia with ropivacaine for postoperative pain after anterior cervical decompression. Methods 60 patients received low-segment cesarean section under the general anesthesia were rondomly divided into 2groups：A group（parecoxib sodium＋1% ropivacaine,30）,B group（sufentanil,30）.Anesthesia was induced and maintained with remifentanil and propofol gived by TCI.Immediately before wound closure,parecoxib sodium 40 mg was injected in group A,1%ropivacaine was injected for local infiltration anesthesia.4μg sufentanil was injected in group B.The self-controlled intravenous analgesia after surgery was performed.The score of ache,sedation and vomit were detected at 4,8,16,24h（T1,T2,T3,T4）after surgery.The score of ache were assessmented by VAS,the score of sedation were assessmented by Ramsay. Results The two groups can provide better postoperative analgesia.The score of Ramsay in B group increased generally,increased significantly compared with A group at T2,T3 after surgery（P〈0.05）.The score of vomit in A group decreased significantly compared with B group at T2,T3 after surgery（P〈0.05）. Conclusion Both parecoxib sodium combined with local infiltration anesthesia with 1% ropivacaine for postoperative pain and the self-controlled intravenous analgesia with sufentanil can provide better postoperative analgesia after anterior cervical decompression.parecoxib sodium combined with local infiltration anesthesia with 1%ropivacaine can decrease the score of Ramsay and the clinical side effect,such as vomit.

关 键 词：帕瑞昔布钠 罗哌卡因 局部浸润 颈椎前路减压术 舒芬太尼 

分 类 号：R681.55[医药卫生—骨科学]