帕瑞昔布钠在小儿腹腔镜阑尾切除术中的超前镇痛作用  

Preemptive analgesia effect of parecoxib sodium on children undergoing laparoscopic appendectomy

作　　者：何建国 袁立勇[2] 陈林[3] 姜娟[4] HE Jianguo YUAN Liyong CHEN Lin JIANG Juan(Department of Anesthesiology, Ningbo Rehabilitation Hospital, Ningbo 315040, Zhejiang , China Ningbo Sixth Hospital, Ningbo 315041, Zhejiang, China Women and Children Hospital of Hubei Province, Wuhan 430070, Hubei, China Women and Children Hospital of Ningbo, Ningbo 315010, Zhejiang, China)

机构地区：[1]宁波市康复医院麻醉疼痛科 [2]宁波市第六医院麻醉科 [3]湖北省妇女儿童医院麻醉科 [4]宁波市妇女儿童医院儿科

出　　处：《中国临床药理学与治疗学》2017年第6期705-708,共4页Chinese Journal of Clinical Pharmacology and Therapeutics

摘　　要：目的:探讨帕瑞昔布钠在小儿腹腔镜阑尾切除术中的超前镇痛作用及其机制。方法:选择全麻下拟行腹腔镜阑尾切除术小儿60例,随机分为实验组和对照组,每组各30例,实验组于麻醉诱导前10 min静脉注射帕瑞昔布钠1 mg/kg,对照组注射等容量生理盐水。术后采用视觉模拟评分法(Visual Analogue Scale/Score,VAS)评估患儿疼痛程度(如患儿不配合按照小儿疼痛评分方法),于麻醉诱导前(T0)、术毕(T1)、术后24 h(T2)及48 h(T3)测定血浆前列腺素E2浓度。观察两组患儿术后躁动、恶心呕吐等并发症的发生率。观察曲马多的使用情况及术后48 h患儿或家属对镇痛的满意度。结果:与对照组相比,实验组患儿术后恶心呕吐、躁动的发生率及曲马多使用率较低,术后48 h时患儿或家属对镇痛的满意度升高(P<0.05)。两组患儿血浆前列腺素E2浓度均在T0、T1和T2时升高,但实验组升高的值小于对照组(P<0.05)。结论:小儿腹腔镜手术前预注射帕瑞昔布钠,可以降低术后血浆前列腺素E2浓度,减轻术后疼痛,并降低术后躁动及恶心呕吐的发生。AIM： To investigate the preemptive analgesia effect of parecoxib sodium and its mechanism in pediatric laparoscopic appendectomy.METHODS： 60 children undergoing laparoscopic appendectomy under general anesthesia were randomly divided into experimental group and control group（ n = 30）. The experimental group was intravenously injected with parecoxib sodium（1 mg/kg）10 min before the anesthesia induction and the control group received equal amount of saline solution.VAS score was used to assess the degree of pain in postoperative children（ non-coordinative children check the FLACC table）; plasma prostaglandin E2 concentrations were measured before anesthesia induction（ T0）,end of operation（ T1）,24 h after operation（ T2） and 48 h after operation（T3）. The incidence of postoperative complications such as restlessness,nausea and vomiting were observed in the two groups. The use of tramadol and the satisfac-tion degree of children or their families were observed 48 h after operation. RESULTS： Compared with the control group,the incidence of postoperative nausea,vomiting,agitation and the use rate of tramadol were lower in the experimental group; the satisfaction degree of the children or their families were higher than the control group 48 h after operation（ P 0. 05）. Plasma prostaglandin E2 concentrations at T0,T1 and T2increased in both groups,but the experimental group was higher than that of the control group（ P 0. 05）. CONCLUSION：Pre-injection of parecoxib sodium before pediatric laparoscopic surgery can reduce the plasma concentration of prostaglandin E2 and alleviate postoperative pain as well as reduce the occurrence of postoperative nausea vomiting and restlessness.

关 键 词：帕瑞昔布钠 小儿 腹腔镜手术 超前镇痛 

分 类 号：R614[医药卫生—麻醉学]