腰椎围手术期病人应用塞来昔布的镇痛效果评估

ANALGESIC EFFECT OF CELECOXIB ON PATIENTS UNDERGOING LUMBAR SURGERY

目的观察腰椎手术病人围手术期应用塞来昔布的镇痛效果。方法62例腰椎手术病人随机分为两组,塞来昔布组30例,术前8h口服塞来昔布400mg,术后6h禁食禁水期过后再次给药,每次200mg,每日2次,术后3～5d视病人疼痛情况停药;镇痛泵组32例,术后常规使用镇痛泵进行镇痛,维持至术后第2天,所有病人术后可根据需要肌注盐酸哌替啶以缓解疼痛。观察两组病人术后6、12、24、48、72h的VAS评分,并记录药物不良反应及盐酸哌替啶援助情况。结果两组病人术后镇痛药物不良反应发生率比较差异有显著性(χ2=5.37,P<0.05),两组术后镇痛药物援助情况比较差异无显著性(P>0.05),镇痛泵组术后6、12h的VAS评分显著低于塞来昔布组(t=4.021、4.724,P<0.01),术后24、48及72h两组VAS评分比较差异无显著意义(P>0.05)。结论腰椎手术病人围手术期应用塞来昔布有一定镇痛效果,但其镇痛效果并不优于镇痛泵。

Objective To evaluate the analgesic effects of celecoxib on patients undergoing lumbar surgery. Methods Sixty-two patients undergoing lumbar surgery were randomized to two groups., celecoxib group （30 cases） received oral administration of celecoxib, 400 mg eight hours before surgery, and 200 mg twice a day starting at six hours after the surgery, the pain killer was discontinued at day 3- 5 based on patients＇ condition; the rest 32 cases were assigned as pain-relieving pump （PRP） group, who received routine analgetic after operation, which lasted for two days. All patients were given intramuscular of 50 mg Pethidine Hydrochloride as required. Pain intensity was evaluated with visual analog scale （VAS） at six, 12, 24, 48 and 72 h after the opera tion, adverse reactions and the Pethidine dosage used were recorded. Results A difference between the two groups in terms of the adverse reactions of pain-killer after the operation was significant （x^2= 5. 37, P〈0.05）, and that of the dosage of Pethidine used was not significant （P〉0.05）. The VAS scores at six and 12 h after surgery in PRP group were dramatically lower than that in celecoxib group （t=4. 021, 4. 724;P〈0.01）, but the differences were not significant at 24, 48 and 72 h after the surgery （P〉 0. 05）. Conclusion Perioperative administration of eelecoxib shows a certain analgesia, but does not surpass the efficacy of intravenous analgesic pump.