摘要
目的:观察帕瑞昔布钠对全麻腹部肿瘤术后的镇痛效果。方法:行全麻腹部肿瘤手术45例,随机平均分为3组,Ⅰ组在手术开始前30 min静脉注射帕瑞昔布40 mg,Ⅱ组在手术结束前30 min静脉注射帕瑞昔布40 mg,Ⅲ组为对照组不给予帕瑞昔布镇痛,3组病人手术结束前45 min均给予负荷量地佐辛0.05 mg/kg,术后均予地佐辛自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)持续镇痛48 h,PCIA配方中地佐辛剂量为0.75 mg/kg;观察3组患者术后0.25 h、2 h、4 h、8 h及24 h的视觉模拟评分(visual analoguescale,VAS),0.25 h的Remesay镇静评分,术后PCIA总使用次数,观察术后48 h内恶心、呕吐、尿潴留、出血、皮肤瘙痒、发热等不良反应。结果:术后0.25 h、2 h,Ⅰ组VAS评分显著高于Ⅱ组,差异有统计学意义(P<0.05);术后24 h内各时点,Ⅲ组的VAS评分显著高于Ⅰ组和Ⅱ组,差异有统计学意义(P<0.05);术后0.25 h,Ⅰ组和Ⅱ组的Remesay镇静评分显著高于Ⅲ组;术后48 hⅢ组的PCIA使用次数显著高于Ⅰ组和Ⅱ组;Ⅲ组患者术后恶心、呕吐、发热、尿潴留的发生率明显高于Ⅰ组和Ⅱ组,差异有统计学意义(P<0.05)。结论:帕瑞昔布钠用于全麻腹部肿瘤手术具有确切的术后镇痛效果,可显著减少地佐辛PCIA的按压次数,降低不良反应发生率。
Objective： To study the analgesic effects of parecoxib in patients after abdominal cancer surgery with general anesthesia. Methods： Forty-five patients accepting abdominal cancer operation with general anesthesia were randomly divided into three groups （n = 15）. All the patients in group I were given 40 mg parecoxib by intravenous injection in 30 min before the surgery, patients in group H received 40 mg parecoxib in 30 min before the end of the surgery ; group m was the control group. E- very patient received a loading dose of 0.05 mg/kg dezocine in 45 min before the end of the surgery, and patient-controlled intravenous analgesia （PCIA） with 0.75 mg/kg dezocine was carried out after the operation. The visual analog scale （VAS） scores in 0.25, 2, 4, 8 and 24 h after operation and Remesay scores were recorded in 0.25 h after operation. The number of using times of PCIA and ad- verse reactions, such as nausea, vomiting, urinary retention, bleeding, skin itching, fever and so on in 48h after operation were recorded. Results： VAS was significantly higher in group Ⅱ than that in group I （P 〈 0.05 ） in 0.25 h and 2 h after surgery ; In 0.25,2, 4, 8 and 24 h, VAS was significant- ly higher in group Ⅲ than that in group Ⅰ and group Ⅱ （P 〈 0.05 ）. Remesay score was significantly higher in group Ⅰ and group Ⅱ than that in group Ⅲ （ P 〈 0.05 ） at 0.25 h and 2 h. The number of using times of PCIA was significantly higher in group Ⅲ than that in group I and group Ⅱ （P 〈 0.05 ）. The incidences of nausea, vomiting, urinary retention and fever in group Ⅲ were significantly more than those in group Ⅰ and group Ⅱ （ P 〈 0.05 ）. Conclusions： Parecoxib has exact analgesic effects after abdominal cancer surgery with general anesthesia, which can reduce the number of using times of dezocine PCIA and adverse reaction rate.
出处
《贵阳医学院学报》
CAS
2014年第2期202-205,共4页
Journal of Guiyang Medical College
关键词
帕瑞昔布
腹部肿瘤手术
术后镇痛
地佐辛
parecoxib
abdominal cancer surgery
postoperative analgesia
dezodine
