摘要
目的探讨分析不同剂量帕瑞昔布钠预处理对直肠癌根治术老年患者术后镇痛的影响。方法选取2014年3月至2018年3月三峡大学第二人民医院收治的直肠癌根治术老年患者260例为研究对象,根据麻醉前预处理帕瑞昔布钠的剂量不同分为帕瑞昔布钠10 mg组、帕瑞昔布钠20 mg组、帕瑞昔布钠40 mg组和对照组,对照组注射0.9%氯化钠溶液。对术后镇痛效果及预后进行观察,比较患者的疼痛度[视觉模拟评分(VAS)]、舒芬太尼用量、不良反应发生情况等。结果各组VAS评分均在术后6 h升高,之后逐渐下降,但帕瑞昔布钠10 mg组、帕瑞昔布钠20 mg组、帕瑞昔布钠40 mg组术后2、6、12、24 h疼痛度显著低于对照组(P<0.05)。帕瑞昔布钠10 mg组、帕瑞昔布钠20 mg组和帕瑞昔布钠40 mg组舒芬太尼用量均少于对照组[(913.62±61.50)μg、(858.37±70.45)μg、(743.98±70.66)μg比(956.45±60.96)μg](P<0.05)。帕瑞昔布钠40 mg组总不良反应发生率低于对照组[4.62%(3/65)比30.77%(20/65)](P<0.05)。结论不同剂量帕瑞昔布钠预处理对直肠癌根治术老年患者术后镇痛效果优良,采用40 mg剂量效果最佳,能显著减少舒芬太尼用量,术后疼痛度低,不良反应少,安全性高。
Objective To investigate the effects of different doses of parecoxib sodium pretreatment on postoperative analgesia in elderly patients undergoing radical resection of rectal cancer. Methods A total of 260 elderly patients undergoing radical rectal cancer in the Second People′s Hospital of China Three Gorges Universtity for treatment from Mar. 2014 to Mar. 2018 were included in the study.They were divided into different groups according to the pretreatment dose of parecoxib sodium before anesthesia：a 10 mg group,a 20 mg group,a 40 mg group and a control group.The study groups received parecoxib sodium 10,20,and 40 mg,respectively,and the control group received 0.9% sodium chloride solution.The postoperative analgesic effect and prognosis were observed,and the patient′s pain（visual analog scale,VAS）, sufentanil dose,and adverse reactions were compared. Results VAS score of each group increased at 6 h after surgery,then gradually declined ;the postoperative pain of 10 mg group,20 mg group and 40 mg group at 2,6,12 and 24 h was significantly lower than that of the control group（ P 〈0.05）.The dosage of sufentanil in the 10 mg group, 20 mg group and 40 mg group was lower than that in the control group[（913.62±61.50） μg,（858.37±70.45） μg,（ 743.98± 70.66） μg vs （956.45±60.96） μg]（ P 〈0.05）.The incidence of total adverse reactions in the 40 mg group was lower than that in the control group[4.62%（3/65） vs 30.77%（20/65）]（ P 〈0.05）. Conclusion Different doses of pare- coxib sodium pretreatment have excellent postoperative analgesia for elderly patients undergoing radical resection of rectal cancer.The 40 mg dose has the best effect,which can significantly reduce the dose of sufentanil,with less postoperative pain,fewer adverse reactions,and high safety.
作者
陈虹宇
李双
汪燕
CHEN Hongyu;LI Shuang;WANG Yan(Department of Anesthesiology,the Second People′s Hospital of China Three Gorges Universtity,Yichang 443000,Chin)
出处
《医学综述》
2018年第14期2910-2913,共4页
Medical Recapitulate
关键词
直肠癌
帕瑞昔布钠
老年患者
术后镇痛
麻醉
剂量
Rectal cancer
Parecoxib sodium
Elderly patients
Postoperative analgesia
Anesthesia
Dose
