帕瑞昔布钠注射液和布桂嗪注射液在PKP手术超前镇痛中的效果对比  

Comparison of the effects of parecoxib sodium and bucinnazine in preemptive analgesia in PKP surgery

作　　者：王春晓 陈树军 唐晓杰 曹海飞 张垚 谭江威 WANG Chunxiao;CHEN Shujun;TANG Xiaojie;CAO Haifei;ZHANG Yao;TAN Jiangwei(Department of Spine Surgery,Yantai Affiliated Hospital of Binzhou Medical University,Yantai 264000,P.R.China)

机构地区：[1]滨州医学院烟台附属医院脊柱外科,山东烟台264000

出　　处：《滨州医学院学报》2022年第4期269-272,共4页Journal of Binzhou Medical University

基　　金：白求恩医学科学研究基金(B19259AN)。

摘　　要：目的探讨帕瑞昔布钠注射液和盐酸布桂嗪注射液在经皮椎体后凸成形术(PKP)手术中超前镇痛的效果。方法选取2020年5月1日至2021年5月1日在我院脊柱外科进行PKP的患者240例,随机分为三组,每组80例。在手术前10 min,观察组肌注帕瑞昔布钠40 mg镇痛,对照组肌注盐酸布桂嗪注射液100 mg镇痛,空白组肌注2 mL生理盐水,比较三组患者手术完成后即刻、6、12、24 h的疼痛评分、手术前后血清炎性因子水平以及不良反应发生情况。结果观察组术后即刻、6、12、24 h的VAS评分分别为(2.6±0.3)、(1.7±0.6)、(1.4±0.5)、(1.0±0.4)分;对照组术后即刻、6、12、24 h的VAS评分分别为(3.0±0.4)、(2.2±0.7)、(1.7±0.6)、(1.4±0.3)分;空白组术后即刻、6、12、24 h的VAS评分分别为(3.8±0.2)、(3.0±0.7)、(2.5±0.1)、(1.9±0.6)分;观察组、对照组以及空白组术后6 h、12 h、24 h的VAS比较,差异有统计学意义(P<0.05)。术后三组患者的IL-6、TNF-α水平、C反应蛋白均升高,但观察组更低,差异具有统计学意义(P<0.05);三组不良反应的总发生率方面,差异具有统计学意义(P<0.05)。结论相比盐酸布桂嗪注射液,帕瑞昔布钠能够更好地缓解PKP术后患者的疼痛感,有效降低术后炎性因子和C反应蛋白的水平,减少炎症反应,镇痛效果更好,且不良反应少。Objective To investigate the effects of parecoxib sodium and bucinnazine in preemptive analgesia for PKP(percutaneous kyphoplasty)surgery.Methods From 1 May,2020 to 1 May,2021,240 patients who underwent PKP in our department were selected and divided into three groups according to random number table method,with 80 patients in each group.Preemptive analgesia(40 mg parecoxib in the observation group 100 mg bucinnazine in the control group,and 2 mL normal saline in the blank group)was applied to patients 10 minutes before the surgery.The VAS(visual analogue scale)of immediate postoperative,and postoperative 6,12,and 24 hours between the three groups were evaluated and compared.The level of preoperative and postoperative serum inflammatory factors and the adverse effects between the three groups were recorded and compared.Results The VAS scores of immediate postoperative,and postoperative 6,12,and 24 hours in the observation group were(2.6±0.3)points,(1.7±0.6)points,(1.4±0.5)points,and(1.0±0.4)points;those in the control group were(3.0±0.4)points,(2.2±0.7)points,(1.7±0.6)points and(1.4±0.3)points;and those in the blank group were(3.8±0.2)points,(3.0±0.7)points,(2.5±0.1)points and(1.9±0.6)points.There was significant difference in VAS scores among the three groups 6,12,and 24 hours after the surgery(P<0.05).The postoperative IL-6,TNF-αlevels and C-reactive protein(C-rp)increased in three groups,but that of the observation group were lower than those of the other two groups,with a statistically significant difference(P<0.05).There was statistically significant difference in the total incidence of adverse reactions among the three groups(P<0.05).Conclusion In comparison with bucinnazine,parecoxib sodium can better relieve the pain of patients after PKP surgery,and effectively reduce the level of postoperative inflammatory factors,leading to better analgesic effects and less adverse reactions.

关 键 词：椎体成形术 帕瑞昔布钠 盐酸布桂嗪 超前镇痛 

分 类 号：R614.1[医药卫生—麻醉学]