摘要
目的探讨新型镇痛药物帕瑞昔布钠(parecoxib sodium)对开胸手术患者全麻苏醒期的影响.方法 178例开胸手术患者随机分为3组:对照组(A组)、芬太尼组(B组)和帕瑞昔布组(C组).患者以丙泊酚、瑞芬太尼等麻醉诱导及维持.关胸前B组患者给予芬太尼0.1 mg,C组患者给予帕瑞昔布钠40 mg.记录停麻醉药后5、10、15、20 min患者动脉血压(MAP)、HR及脑电双频指数(BIS),记录苏醒期躁动的发生,记录患者苏醒时间,测定患者入室5 min动脉血氧分压(PaO)2及血氧饱和度(SaO2%)并记录患者在PACU驻留时间.结果 (1)停麻醉药后10、15及20 min,B、C组MAP明显低于A组(P<0.05,0.01);与A组相比,B组停药后及C组停药后15、20 min心率明显降低;(2)B组停药后5、10 min BIS值明显低于A、C 2组;(3)B组苏醒时间明显长于A组(P<0.05);C组PACU驻留时间明显短于A组(P<0.05);(4)B、C 2组苏醒期躁动发生率明显低于A组(P<0.05);(5)C组SaO2及PaO2明显高于其余2组(P<0.05).结论镇痛药物帕瑞昔布钠可明显改善开胸手术患者术后通气,缓解循环波动,缩短苏醒时间及PACU驻留时间.
Objective To determine the effectiveness of perioperative parecoxib sodium injection on preventing cardiopulmonary and mental complications during general anesthetic recovery after thoracotomy.Methods One hundred and seventy eight patients receiving thoracotomy under general anesthesia were randomly divided into 3 groups：control group（Group A,n=55）,fentanyl group（Group B,n=61,fentanyl 0.1 mg,i.v.,before the discontinuation of anaesthesia） and parecoxib sodium group（Group C,n=62,parecoxib sodium 40 mg,i.v.,before the discontinuation of anaesthesia）.The mean artial pressure（MAP）,heart rate（HR） and bispectral index monitoring（BIS） were measured at 5,10,15 and 20 min after the discontinuation of anaesthesia.The mobidity of emergence agitation（EA） and recovery time were recorded.The patients were presented to the postanesthesia care unit（PACU） with endotracheal tubes after anesthetic recovery.The arterial partial pressure of oxygen（PaO）2 and oxygen saturation（SaO）2 were calculated at five minutes after PACU admission without the inspiration of oxygen.The duration of stay in the PACU was also collected.Results Baseline demographics and anesthetic medication were similar.No significant differences were noted in the duration of surgery and the volume of intraoperative infusion and transfusion between the three groups.MAP in Group B and C was significantly lower than that in Group A（P〈0.05 and 0.01,respectively） at 10,15 and 20 min after the discontimuation.Compared with Group A,HR in Group B and C was significantly lower at 15 and 20 min after the discontimuation.BIS in Group B was significantly lower than that in Group A and C at 5 and 10 min after the discontinuation.Recovery time in Group B was significantly more prolonged than that in Group A（P〈0.05）.The duration of stay in Group C was significantly shorter than that in Group A.The mobidity of agitation during anesthetic recovery in Group B and C was significantly lower than that in Group A（P〈0.05）.PaO 2 and
出处
《昆明医科大学学报》
CAS
2012年第8期37-40,共4页
Journal of Kunming Medical University
基金
云南省应用基础研究基金资助项目(2010ZC179)
关键词
帕瑞昔布钠
开胸手术
全身麻醉
苏醒
躁动
Parecoxib sodium
Thoracotomy
General Anesthesia
Recovery
Emergence agitation
