帕瑞昔布钠用于高原地区剖腹术后镇痛30例  

Effect of Parecoxib Sodium in the Treatment of 30 Cases of Postoperative Analgesia of Laparotomy in Plateau Area

作　　者：金叶媛 鲁晓红[1] 李祥[2] JIN Yeyuan;LU Xiaohong;LI Xiang(Shaanxi University of Chinese Medicine,Xianyang 712000,China;Department of Anesthesiology,the People's Hospital of Qinghai Provincial,Xining 810001,China)

机构地区：[1]陕西中医药大学,咸阳712000 [2]青海省人民医院麻醉科,西宁810001

出　　处：《医药导报》2018年第5期572-575,共4页Herald of Medicine

基　　金：高原地区多模式镇痛的机制研究(2012-Z-756)

摘　　要：目的观察帕瑞昔布钠对高原地区手术后疼痛的有效性及安全性。方法选取连续硬膜外麻醉下行择期胆囊切除术患者60例,随机分为两组,各30例。帕瑞昔布钠组(P组),手术开始前、结束后分别给予帕瑞昔布钠40 mg,用0.9%氯化钠溶液稀释到5 mL静脉推注;对照组(C组)手术开始前、结束后给予0.9%氯化钠溶液5 mL静脉推注;两组均抽取手术开始前10 min(t_0)、手术后(t_1)及手术后24 h(t_2)静脉血样。记录手术后4,8,12,24,36及48 h Ramsay镇静评分、视觉模拟评分(VAS)及氧饱和度(SpO_2);t_0、t_1、t_2测定静脉血促肾上腺皮质激素(ACTH)、前列腺素E_2(PGE_2)的浓度;记录手术后排气时间。结果两组患者的Ramsay评分、SpO_2及排气时间差异无统计学意义;P组手术后4,8,12,24 h VAS评分明显低于C组(P<0.05),两组在48和72 h VAS评分差异无统计学意义;两组于t_0时ACTH水平及PGE_2差异均无统计学意义,t_1、t_2时P组ACTH及PGE_2均明显低于C组(P<0.05)。结论帕瑞昔布钠用于高原地区剖腹术后镇痛不仅可有效缓解手术后疼痛,减轻患者手术后应激反应,而且无过度镇静、缺氧,也不增加患者排气时间。Objective To observe the efficacy and safety of parecoxib sodium in postoperative pain of laparotomy in plateau area.Methods Sixty patients scheduled for open cholecystectomy under continuous epidural anesthesia were enrolled and randomly divided into two groups(n=30):group P and group C.Patients in group P received parecoxib sodium 40 mg in 5 mL 0.9%sodium chloride solution before and after operation.Patients in group C received 0.9%sodium chloride solution 5 mL instead of parecoxib sodium.Venous blood samples were obtained from the two groups at 10 min before the surgery(t 0),immediately after surgery(t 1)and at 24 h after surgery(t 2).The Ramsay sedation scores,visual analogue scale(VAS scores)and oxygen saturation(SpO 2)were recorded at 4,8,12,24,36 and 48 h after the surgery.Concentration of adrenocorticotrophic hormone(ACTH)and prostaglandin E 2(PGE 2)were measured at t 0,t 1,t 2 The postoperative exhausing time was also recorded.Results There were no significant differences between the two groups in the Ramsay sedation scores、SpO 2 and the postoperative exhausing time.But VAS scores were significantly lower in group P at 4,8,12,24 h after surgery than group C(P<0.05)and have no significant differences at 48 and 72 h after surgery.There were no significant differences of ACTH and PGE 2 between the two groups at t 0.ACTH and PGE 2 was significant lower in P at t 1,t 2(P<0.05).Conclusion Parecoxib sodium could efficiently relieve the postoperative pain in plateau area,relieving the stress reaction without excessive sedation,anoxia and prolonging of the postoperative exhaust time.

关 键 词：帕瑞昔布钠 高原地区 疼痛 手术后 剖腹术 

分 类 号：R971[医药卫生—药品] R656[医药卫生—药学]