帕瑞昔布钠在经产妇剖宫产术后减轻子宫收缩痛的观察  

Parecoxib relieves the pain of uterine contraction after cesarean section in multipara

作　　者：徐一刚[1] 孙正英[2] 孙杰[3] 钱燕宁[3] 

机构地区：[1]南京医科大学附属江苏盛泽医院麻醉科,苏州市215228 [2]南京医科大学附属江苏盛泽医院妇产科,苏州市215228 [3]南京医科大学第一附属医院麻醉科

出　　处：《临床麻醉学杂志》2015年第9期885-887,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察帕瑞昔布钠在经产妇剖宫产术后减轻子宫收缩痛的作用。方法选取需择期剖宫产手术经产妇80例,ASAⅠ或Ⅱ级,单胎足月,随机均分为两组:帕瑞昔布钠组(P组),帕瑞昔布钠40mg用生理盐水稀释到5ml;对照组(C组),生理盐水5ml,分别于胎儿娩出断脐后静脉推注(大于1min),术后接硬膜外镇痛泵。术后如出现子宫收缩疼痛,可肌注哌替啶50mg。记录胎儿娩出后子宫复旧程度,术中是否应用其他缩宫药物;记录恶心、呕吐等不良反应的发生情况。记录产后2、4、8和24h子宫收缩疼痛(VAS)评分和睡眠情况。有无应用哌替啶及计算产后24h出血量。结果两组子宫复旧程度和胃肠道不良反应差异无统计学意义,术中两组含服米索前列腺素片及其他宫缩药物差异无统计学意义。P组术后2、4、8h子宫收缩痛VAS评分明显低于C组(P<0.05);P组睡眠质量明显好于C组(P<0.05);P组需要肌注哌替啶的例数明显低于C组(P<0.05)。两组间产后24h出血量差异无统计学意义。结论帕瑞昔布钠可减轻经产妇产后子宫收缩痛,而不增加产后24h出血量和不良反应。Objective To observe the effect of parecoxib on uterine contraction pain in multipa- ra after cesarean section. Methods Eighty ASA I or Ⅱ multiparas at term of pregnancy, undergoing cesarean section during spinal anesthesia were enrolled and randomly divided into two groups ： group P and group C. After baby delivery and umbilical cord occlusion, the multiparas in group P received parecoxib 40 mg in 5 ml saline within one minute. Group C multiparas received normal saline 5 ml. All the multiparas received epidural analgesia pump after surgery and meperidine 50 mg intramuscular as needed. The VAS scores were recorded 2, 4, 8 and 24 hours after surgery. The sleep quality, ute- rus tension, postpartum hemorrhage, additional using of uterus contraction drugs or paregoric drugs and adverse effects were also recorded. Results There was no significant difference in uterus tension, postpartum hemorrhage, additional uterus contraction drug, use of meperidine and adverse effect be- tween the two groups. But the VAS scores were lower in group P at 2,4,8 hous after surgery （P〈 0. 05）. The sleep quality of group P was also better than that of group C （P〈0.05）. More multipa- ras in group C needed additional meperidine （P〈0.05）. Conclusion Parecoxib can relieve the uterine contraction pain in multipara under cesarean section without more adverse effect.

关 键 词：帕瑞昔布钠 经产妇 子宫收缩痛 

分 类 号：R614[医药卫生—麻醉学]