塞来昔布与地佐辛联合舒芬太尼对盆骨骨折的临床镇痛效果评价  

Clinical analgesic effect of celecoxib and dezocine combined with sufentanil on pelvic fracture

作　　者：杜靓[1] 陈钢[1] 孔来法 DU Liang;CHEN Gang;KONG Lai-fa(Department of Emergency Surgery,Jinhua Central Hospital,Jinhua 321000,Zhejiang Province,China)

机构地区：[1]金华市中心医院急诊外科,浙江金华321000

出　　处：《中国临床药理学杂志》2022年第10期1030-1033,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的观察塞来昔布与地佐辛联合舒芬太尼对盆骨骨折临床镇痛的疗效。方法将100例盆骨骨折患者随机分为塞来昔布组(S组,n=50)和地佐辛联合舒芬太尼组(DS组,n=50),S组术前3天口服塞来昔布胶囊200 mg,bid,术前1 h口服塞来昔布胶囊200 mg,术后6 h口服塞来昔布胶囊400 mg,此后给予塞来昔布胶囊200 mg/12 h;DS组术后采用经静脉患者自控镇痛(PCIA,1μg·kg^(-1)舒芬太尼+0.3 mg·kg^(-1)地佐辛溶于0.9%氯化钠100 mL)。对比2组术后临床疗效情况,以及药物不良反应发生的情况。结果DS组术后2,6,12,24和48 h视觉模拟评分(VAS)分别为(3.48±0.96),(2.80±0.72),(2.70±0.61),(2.42±0.64)和(2.36±0.62)分,S组分别为(4.18±1.11),(4.80±0.82),(3.30±0.83),(2.90±0.70)和(2.60±0.53)分,差异均有统计学意义(均P<0.05)。术后12 h,S组和DS组超氧化物歧化酶(SOD)表达量分别为(73.21±5.44)和(75.48±5.78)U·mL^(-1),人丙二醛(MDA)表达量分别为(7.90±1.23)和(6.66±0.82)μmol·L^(-1),差异均有统计学意义(均P<0.05)。术后2 h,S组和DS组血浆肾上腺素分别为(503.47±78.14)和(464.39±71.18)ng·L^(-1),去甲肾上腺素水平分别为(775.51±89.62)和(719.42±89.09)ng·L^(-1),差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均以恶心呕吐、头晕嗜睡等症状为主,DS组和S组的总药物不良反应率分别为14.0%和16.0%(P>0.05)。结论地佐辛联合舒芬太尼用于盆骨骨折术后较塞来昔布镇痛镇静效果更好,能有效缓解患者应激反应。To compare the clinical analgesia effect of celecoxib and dezocine combined with sufentanil on pelvic fractures.Methods Totally 100 patients with pelvic fracture were randomly divided into celecoxib group(S group,n=50)and desocine combined with sufentanil group(DS group,n=50).Group S was orally given celecoxib 200 mg,3 days before surgery,twice a day,celecoxib 200 mg at 1 hour before surgery,celecoxib 400 mg at 6 hours after surgery,celecoxib capsule 200 mg/12 h was then given.Patients in DS group were treated with patient-controlled intravenous analgesia(PCIA,1μg·kg^(-1) sufentanil+0.3 mg·kg^(-1) desocine dissolved in 0.9%NaCl 100 mL).The postoperative clinical efficacy of the two groups and the occurrence of adverse drug reactions were compared.Results The visual analogue scale(VAS)at 2,6,12,24 and 48 h after operation in DS group were(3.48±0.96),(2.80±0.72),(2.70±0.61),(2.42±0.64),(2.36±0.62)scores,which in S group were(4.18±1.11),(4.80±0.82),(3.30±0.83),(2.90±0.70),(2.60±0.53)scores;the differences were statistically significant(all P<0.05).The levels of superoxide dismutase(SOD)at 12 h after operation in S and DS groups were(73.21±5.44),(75.48±5.78)U·m L^(-1),malondialdehyde(MDA)were(7.90±1.23),(6.66±0.82)μmol·L^(-1),the differences were statistically significant(all P<0.05).At 2 h after operation,plasma adrenaline levels in S group and DS group were(503.47±78.14),(464.39±71.18)ng·L^(-1);norepinephrine levels were(775.51±89.62),(719.42±89.09)ng·L^(-1);the differences were statistically significant(all P<0.05).The adverse drug reactions of the two groups were mainly nausea,vomiting,dizziness,drowsiness and other symptoms.The total adverse drug reaction rates in DS group and S group were 14.0%and 16.0%,respectively(P>0.05).Conclusion Dezocine combined with sufentanil has better analgesic and sedative effect than celecoxib in the treatment of pelvic fracture and can effectively relieve the stress response of patients.

关 键 词：塞来昔布 地佐辛 舒芬太尼 术后镇痛 镇静 盆骨骨折 氧化应激 

分 类 号：R97[医药卫生—药品]