摘要
目的对比观察术后静脉推注帕瑞昔布、曲马朵对腹腔镜胆囊切除术后的镇痛效果。方法将2017年3月至2018年3月该院肝胆外科收治的180例行腹腔镜胆囊切除术患者采用随机数字表法分为A组和B组,每组90例。A组患者回病房后即刻静脉推注帕瑞昔布40mg,B组患者回病房后即刻肌内注射曲马朵2mg/kg,两组患者12h后均重复给药1次。两组患者术前均采用气管插管全身麻醉,手术结束前均静脉滴注昂丹司琼8mg。记录两组患者给药后2、4、6、8、12、24h疼痛视觉模拟评分、发生不良反应(恶心、呕吐、呼吸抑制、凝血功能异常)和追加哌替啶的情况。结果两组患者术后2、4、6、8、12、24h疼痛视觉模拟评分比较,差异均无统计学意义(P>0.05)。A组患者恶心、呕吐发生率[10.0%(9/90)]明显低于B组[40.0%(36/90)],差异有统计学意义(P<0.05);两组患者均未出现呼吸抑制、凝血功能异常等不良反应。A组患者中术后使用哌替啶3例(3.33%),B组患者中使用哌替啶6例(6.67%),两组患者追加使用哌替啶情况比较,差异无统计学意义(P>0.05)。结论两种方法均具有较好的镇痛效果,静脉推注帕瑞昔布恶心、呕吐发生率明显低于肌内注射曲马朵。腹腔镜胆囊切除术后患者回病房即刻、术后12h静脉推注帕瑞昔布镇痛具有显著的临床意义,值得推广应用。
Objective To paired observation effects of intravenous injection of parecoxib and tramadol for analgesia in patients under went laparoscopic cholecystectomy(LC). Methods A total of 180 patients under went LC in the Department of Hepatobiliary Surgery from March 2017 to March 2018 were randomly divided into two groups:A and B,90 cases in each group.Patients in Group A received 40 mg of parecoxib immediately when back to the ward.Patients in Group B received tramadol 2 mg/kg.Two groups of patients were given repeated administration once after 12 hours.Both groups were given general anesthesia by tracheal intubation before operation,and ondansetron 8 mg intravenously after operation.Visual analogue scores of pain,adverse reactions (nausea,vomiting,respiratory depression,abnormal coagulation function) and pethidine addition were recorded 2,4,6,8,12 and 24 hours after giving drugs. Results There were no significant difference in the VAS scores between the two groups after 2,4,6,8,12 hours and 24 hours of operation ( P >0.05).In group A,nausea and vomiting occurred in 9 cases (10.0%),which was lower than that in group B (36 cases,40.0%),and the difference was statistically significant ( P <0.05).No adverse reactions such as respiratory depression and abnormal coagulation function were found in the 2 groups.Pethidine was used in 3 cases (3.33%)in group A and in 6 cases (6.67%) in group B,and there was no significant difference in the addition of pethidine in the two groups of A and B ( P >0.05). Conclusion Relatively good analgesic effect obtained in two groups.The incidence of nausea and vomiting by intravenous injection of parecoxib was significantly lower than that by intramuscular injection of tramadol.Intravenous injection of parecoxib when patients returned to the ward immediately and 12 hours after laparoscopic cholecystectomy has significant clinical significance for analgesia and is worthy of popularization and application.
作者
石小莉
何琴
肖衡
罗盛淑
SHI Xiaoli;HE Qin;XIAO Heng;LUO Shengshu(Department of Hepatobiliary Surgery,the First Affiliated Hospital of ChongqingMedical University,Chongqing 400042,China)
出处
《现代医药卫生》
2019年第8期1127-1128,1132,共3页
Journal of Modern Medicine & Health
基金
NSFC青年科学基金项目(81702408)
重庆医科大学附属第一医院科研基金资助项目(HLJJ2012-18)
关键词
曲马朵
胆囊切除术
腹腔镜
镇痛
随机对照试验
帕瑞昔布
Tramadol
Cholecystectomy,laparoscopic
Analgesia
Randomized controlled trial
Parecoxib
