帕瑞昔布超前镇痛在小儿扁桃体切除术中的应用  

The Clinical Observation of Parecoxibin Preemptive Analgesia in childen undergoing tonsillectomy

作　　者：曾秋谷 黎达锋 岑相如 杨奕尤 黎瑶瑶 陈显琴 

机构地区：[1]阳江市人民医院麻醉科,广东阳江529500

出　　处：《吉林医学》2017年第11期2033-2036,共4页Jilin Medical Journal

摘　　要：目的:观察帕瑞昔布钠超前镇痛在小儿扁桃体切除术后的阿片节俭作用、镇痛效果及不良反应。方法:选取气管插管全麻下择期行扁桃体切除手术的60例患儿为研究对象。随机分为帕瑞昔布钠组(A组)和对照组(B组)各30例。于手术开始前15 min分别注射帕瑞昔布钠1 mg/kg或等量0.9%Na Cl溶液。观察两组患儿术后需要芬太尼补救的例数总剂量、镇痛镇静评分和躁动评分以及不良反应。结果:A组患者术中瑞芬太尼用量明显少于B组,需要镇痛补救的例数和术后补救芬太尼的总量A组明显少于B组(P<0.05)。A组躁动评分明显低于B组(P<0.05)。患儿术后1 h、6 h、8 h的疼痛评分A组明显低于B组(P<0.05),患儿术后1 h、6 h的镇静评分A组明显低于B组(P<0.05),A组恶心、呕吐的发生率较B组低(P<0.05),差异均有统计学意义。两组呼吸抑制、皮肤瘙痒、尿潴留发生率都不高,两组均没有出现一例术后出血等严重并发症。结论:在小儿扁桃体手术术前15 min静脉注射帕瑞昔布钠1 mg/kg可以产生良好的镇痛作用,可减少术后躁动、芬太尼的用量及患儿恶心、呕吐的发生率。Objective To discuss the effect and untoward reaction of preemptive analgesia with Parecoxib sodium in children undergoing tonsillectomy. Method Sixty children undergoing tonsillectomy were randomly divided into two groups with 30 cases in each group. Group A was Parecoxib sodium Group,group B was control group. In group A,1 mg/kg Parecoxib sodium was administered intravenously 15 minutes before the beginning of operation,cases in group B received normal saline. observe the number of patients requiring rescue fentanyl,doses of postoperative rescue fentanyl,the agitation score after extubation,The pain score and sedation score and adverse effects. Results The remifentanil consumption in group A during the operation was lower than that in group B（ P〈0. 05）. The number of patients requiring rescue fentanyl and doses of postoperative rescue fentanyl in group A were lower than that in group B（ P〈0. 05）. The agitation score 10 minutes after extubation in group A was lower than that in group B（P〈0. 05）. The pain score in group A at 1、6 and 8 h was lower than that in group B after operation（P〈0. 05）. The sedation score in group A at 1 and 6 h was lower than that in group B（ P〈0. 05）. The incidence of postoperation nausea or vomiting（PONV）in group A was significantly lower than that in group B（P〈0. 05）. No significant respiratory depression or pruritus,and no abnormal hemorrhage was observed in both group. Conclusion In the children undergoing tonsillectomy,preemptive analgesia with Parecoxib sodium has a good postoperative analgesic effect and has less side effect.

关 键 词：环氧化酶2抑制剂 镇痛 扁桃体切除术 儿童 

分 类 号：R726.1[医药卫生—儿科]