帕瑞昔布钠超前镇痛预防全麻苏醒期导尿管源性躁动的效果  

Efficacy of Parecoxib Sodium for preemptive analgesia in prevention of catheter induced agitation during recovery period of general anesthesia

作　　者：杨鑫[1] 沈荣荣[1] 李琳[1] 楼其锋 YANG Xin SHEN Rongrong LI Lin LOU Qifeng(Department of Anesthesiology, the People＇s Hospital of Yuyao City, Zhejiang Province, Yuyao 315400, China)

机构地区：[1]浙江省余姚市人民医院麻醉科,浙江余姚315400

出　　处：《中国医药导报》2017年第1期73-77,共5页China Medical Herald

基　　金：浙江省余姚市人民医院院级课题计划项目(YJ07B)

摘　　要：目的评价帕瑞昔布钠超前镇痛预防全麻苏醒期导尿管源性躁动的效果。方法选择2014年1月~2016年1月余姚市人民医院择期普胸手术患者144例,性别不限,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级。将患者随机分成四组,每组各36例。其中,A组留置导尿管前半小时静注帕瑞昔布钠35 mg,B组在关闭胸腔时静注帕瑞昔布钠35 mg,C组在关闭胸腔时静注芬太尼0.1 mg,D组在关闭胸腔时静注生理盐水10 m L。记录四组患者苏醒时间、麻醉后监测治疗室(PACU)滞留时间、视觉模拟评分(VAS)、Ramsay镇静评分(RSS)、躁动分级;观察四组患者气管导管拔除后0、2、4、6 h对留置导尿管引起刺激的反应严重程度;记录患者在麻醉期后嗜睡、呼吸抑制、舌后坠等不良反应发生情况。结果 A、B、C组的PACU滞留时间、VAS评分、RSS评分均显著优于D组(P<0.05),且A组效果更为显著(P<0.05);四组间躁动分级情况比较,A组显著优于其他各组(P<0.05)。A、B、C组的导尿管刺激程度均显著优于D组(P<0.05),且A组效果更为显著(P<0.05)。A、B、C组的嗜睡、呼吸抑制、舌后坠发生率明显低于D组(P<0.05),三组间比较差异无统计学意义(P>0.05)。结论帕瑞昔布钠超前镇痛可减轻全麻苏醒期导尿管源性躁动。Objective To observe the effect of Parecoxib Sodium preemptive analgesia in prevention of catheter induced agitation during recovery period of general anesthesia. Methods 144 cases of patients with ASA Ⅰ-Ⅱunderwent selective thoracic operation in People＇s Hospital of Yuyao City from January 2014 to January 2016 were selected and divided into 4 groups randomly, each group had 36 cases. Patients in group A were given 35 mg Parecoxib Sodium analgesia half an hour before the detaining urethral catheter; patients in group B were given 35 mg Parecoxib Sodium at the time of closing the chest; patients in group C were given 0.1 mg Fentanyl at the time of closing the chest; while patients in group D were given 10 m L saline solution at the time of closing the chest. In the 4 gorups the wake up of time, PACU stay time, VAS score, Ramsay sedation score（RSS）, agitation classification were recorded; the irritation reaction severity of detaining urethral catheter were observed in patients with tracheal catheter removal after 0, 2, 4, 6 h; the adverse reactions after anesthesia period including sleepiness, respiratory depression, tongue retropulsion were recorded. Results The PACU stay time, VAS scores, RSS scores of group A, B, C were better than those of group D（P〈0.05）,while group A had the best effects（P〈0.05）. The agitation classification of gorup A was better than other gorups, with statistically significant difference（P〈0.05）. The irritation reaction severities of detaining urethral catheter of group A,B, C were better than those of group D（P〈0.05）, while group A had the best effects（P〈0.05）. The incidence of sleepiness, respiratory depression, tongue retropulsion were lower in gorup A, B, C than in gorup D（P〈0.05）, while in gorup A, B, C had no statistically significant difference（P〈0.05）. Conclusion Parecoxib Sodium analgesia in advance can decrease general awakening period catheter-related bladder agitation.

关 键 词：环氧化酶2抑制剂 镇痛 精神运动性激动 导尿管插入术 麻醉恢复期 

分 类 号：R614.2[医药卫生—麻醉学]