帕瑞昔布钠与曲马多对七氟醚麻醉后苏醒期躁动的比较

Comprasion of parecoxib sodium and tramadol in sevoflurane general anasthesia

目的比较术前应用帕瑞昔布钠和曲马多对七氟醚全身麻醉后苏醒期躁动的预防作用。方法将60例ASAⅠ或Ⅱ级择期肝胆手术患者随机分为帕瑞昔布钠组（A组）、曲马多组（B组）和对照组（C组）。分别于麻醉诱导前（T1）、拔管前（停药10min，T2）、拔管时（T3）、拔管后10min（T4）观察三组MAP、HR、SpO2，并记录睁眼时间、拔管时间、术后疼痛评分和躁动分级。结果T2～T4时A、B组MAP、HR明显低于C组（P〈0．05或P％0．01）。因吸氧无一例患者SpO2降低。A、C组睁眼及拔管时间明显短于B组（P〈0．05或P〈0．01）。A、B组躁动发生率明显低于C组（P〈0．05或P〈0．01）。术后30min、2h A、B组VAS评分明显低于C组（P〈0．05）。结论帕瑞昔布钠和曲马多用于七氟醚全身麻醉可产生良好的超前镇痛作用，并可预防术后躁动的发生，但曲马多对患者的苏醒有延迟作用。

Objective To observe the effect of preemptive analgesia with pareeoxib sodium and tramadol on sevoflurane general anasthesia and evaluate the preventive effect of parecoxib sodium and tramadol on postoperative agitation. Methods Sixty ASA Ⅰ or Ⅱ patients undergoing hepatolobectomy or cholecystectomy were randomly divided into 3 groups（n = 20 each）： group A （parecoxib sodium）, group B（tramadol）, group C（control）. Heart rate （HR）, mean arterial blood pressure（MAP） ,and saturation of pulse oxygen（SpO2 ） were recorded before induction of anesthesia and around extubation. The times of eyes opening, extubation and the degree of postoperative agitation were recorded. Results The MAP, HR of A and B group were lower than that in group C at T2-T4 （P〈0.05 or P〈0.01）. The times of eyes opening and extubation in A group were shorter than that in B group（P〈0.05）. The incidence of postoperative agitation in A group and B group werelower than that in group C（P〈0.05 or P〈0.01）, the VAS in group A and group B were lower than that in group C after the operation 0.5, 2 h （P〈0.05）. Conelusion In sevoflurane general anasthesia, parecoxib sodium and tramadol can induce preemptive analgesia and prevent postoperative agitation. However,trammadol can prolong the waking time of patients.