帕瑞昔布钠用于腹腔镜胆囊切除术后镇痛临床观察(1)
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[摘要] 目的 探讨帕瑞昔布钠超前镇痛对腹腔镜胆囊切除术后镇痛的有效性。 方法 选择ASAⅠ或Ⅱ级拟在全麻下行腹腔镜胆囊切除术的患者50例，男女不限，随机分为A、B两组，每组25例，两组患者麻醉诱导及麻醉维持用药相同。A组患者在麻醉后静脉注射帕瑞昔布钠40 mg(生理盐水稀释至4 mL)，B组患者同一时间注射生理盐水4 mL。记录手术时间、术中芬太尼用量、清醒拔管时间，术后3、6、12、24 h专人负责VAS评分，并记录24 h内止痛药使用例数及次数，恶心呕吐等不良反应。 结果 两组手术时间、术中芬太尼用量、清醒拔管时间比较差异无统计学意义。A组术后3、6、12 h VAS评分低于B组(P < 0.05)。B组术后需使用哌替啶止痛的患者例数明显高于A组(P < 0.05)，术后不良反应两组比较差异无统计学意义。 结论 术前静脉注射帕瑞昔布钠40 mg超前镇痛，可明显减轻腹腔镜胆囊切除术后疼痛反应，具有操作简单、效果明显等优点。
[关键词] 环氧化物酶-2抑制药；帕瑞昔布钠；超前镇痛；腹腔镜胆囊切除术
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2012)02(b)-0074-02
Clinical observation of Parecoxib sodium for laparoscopic cholecystectomy analgesia
LIAO Lixing LIANG Dashun WU Wei YANG Zuotian LU Mei
Department of Anesthesia, Guangdong Provincial Nongken Central Hospital, Guangdong Province, Zhanjiang 524002, China
[Abstract] Objective To investigate the effectiveness of Parecoxib sodium for laparoscopic cholecystectomy analgesia. Methods Selecting 50 cases the level of ASAⅠ-Ⅱ to be anesthesiaed for laparoscopic cholecystectomy, who were randomly divided into A, B groups, each group had 25 cases. The two groups were treated with the same medication in induction of anesthesia and maintain anesthesia. Patients of group A were treated with intravenous Parecoxib sodium 40 mg after anesthesia (normal saline diluted to 4 mL). Patiens of group B were received normal saline 4 mL at the same time. The operative time, fentanyl dosage, awake extubation time were recorded in the two groups, VAS scores were recorded at 3, 6, 12, 24 h, and the times of pain medication, the adverse reactions such as nausea and vomiting were recorded within 24 h. Results The two groups of operative time, intraoperative fentanyl dosage, awake extubation time were compared, the differences were not statistically significant. The 3, 6, 12 h VAS scores of group A were lower than group B (P < 0.05). Patients of group B who needed pain relief with pethidine were significantly more than group A (P < 0.05). The adverse reactions of postoperative between the two groups were not statistically significant. Conclusion Pre-operative intravenous Parecoxib sodium 40 mg treatment can significantly reduce the pain response after laparoscopic cholecystectomy, that is simple and obvious effect ......
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