摘要
目的:探讨帕瑞昔布钠用于肾移植术后患者的镇痛效果和安全性,为肾移植患者术后镇痛药物的使用提供临床依据。方法:选择行同种异体肾移植术患者48例,随机分为帕瑞昔布组、芬太尼组和对照组,每组16例。分别在停用麻醉药前10min通过静脉给予患者帕瑞昔布40mg、芬太尼0.1mg和生理盐水2mL。观察各组患者拔管前5min(T1)、拔管即刻(T2)、拔管后5min(T3)、拔管后10min(T4)血流动力学变化,同时记录患者有无呛咳、恶心及呕吐,评价患者镇静和镇痛评分。比较3组患者术前、术后12h、术后36h尿量及血清肌酐(SCr)、尿素氮(BUN)水平。结果:3组患者手术时间、术中输液量和住院天数比较差异均无统计学意义(P>0.05)。与T1时间点比较,对照组患者在T2、T3和T4时间点收缩压(SBP)水平均升高(P<0.05);与T1时间点比较,芬太尼组患者在T3、T4时间点血氧饱和度(SpO2)水平降低(P<0.05);而帕瑞昔布钠组患者的血流动力学指标在T1、T2、T3和T4时间点比较差异均无统计学意义(P>0.05)。与对照组比较,帕瑞昔布钠组和芬太尼组患者呛咳躁动的发生率明显降低(P<0.05);3组患者恶心及呕吐的发生率组间比较差异均无统计学意义(P>0.05);与对照组比较,帕瑞昔布钠组和芬太尼组术后镇痛药曲马多的使用次数减少;术前、术后3组患者的尿量、血清BUN和SCr水平比较差异均无统计学意义(P>0.05)。在术后镇痛方面,芬太尼组患者术后镇痛评分与对照组比较差异无统计学意义(P>0.05);帕瑞昔布钠组患者术后镇痛评分低于其他2组,差异有统计学意义(P<0.05)。在术后镇静方面,芬太尼组患者术后镇静评分低于其他2组(P<0.05)。结论:帕瑞昔布钠静脉注射可以用于肾移植术后镇痛和镇静,副作用相对较小。
Objective To determine the effect and safety of parecoxib sodium on postoperative analgesia in patients after renal transplantation, and to provide basis for application of analgesia medicine for patients after renal transplantation. Methods Forty-eight patients underwent renal allogeneic transplantation were randomly divided into parecoxib sodium group, fentanyl group, and control group, and there were 16 patients in each group. The patients in three groups were given parecoxib sodium 40 rag, fentanyl 0.2 mg and saline 2 mL, respectively. The hemodynamie parameters of patients in various groups were recorded at 5 min before extuhation (T1), extubation time (T2), 5 rain after extubation (T3) and 10 min after extubation (T4) ; and the occurrence of cough, nausea and vomiting of patients were recorded; the postoperative pain and sedation levels were evaluated; the urine output, the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) of patients in various groups before operation and 12, 36 h after operation were compared. Results There were no significant differences of operation time, intraoperative infusion amount and hospitalization time of patients between various groups (P 〈 0.05). Compared with T1 time point, the SBP levels of patients at T2, T3 and T4 in control group were increased (P〈0. 05); compared with T1 time point, the levels of oxygen saturation (SpO2) of patients at T3 and T4 in fentanyl group were decreased (P〈0.05). There were no significant differences of hemodynamic parameters of patients in parecoxib sodium group at T1, T2, T3 and T4 time points (P2〉 0.05). Compared with control group, the incidence rates of tussis and dysphoria of patients in parecoxib sodium group and fentanyl group were decreased (P〈0.05); there were no siginificant differences of the incidence rates of nausea and vomiting between various groups (P〈0.05). Compared with control group, the using times of tramadol hydrochloride of patients in parecoxib s
出处
《吉林大学学报(医学版)》
CAS
CSCD
北大核心
2013年第1期138-142,共5页
Journal of Jilin University:Medicine Edition
基金
吉林省科技厅国际合作项目资助课题(20110759)
关键词
帕瑞昔布钠
肾移植
术后疼痛
术后镇痛
血流动力学
parecoxib sodium
renal transplantation
postoperative pain
postoperative analgesia
hemodynamics