赛来昔布和帕瑞昔布钠用于围术期镇痛的效果观察

The effect observation of perioperative analgesia using of celecoxib and parecoxib

目的观察赛来昔布和帕瑞昔布钠用于围术期镇痛的效果。方法将髋关节置换、膝关节置换和脊柱手术患者72例随机分为2组,试验组42例采用赛来昔布和帕瑞昔布钠进行围术期镇痛,在术前2h给予赛来昔布400mg、术后即刻给予帕瑞昔布钠40mg肌内注射、以后每12小时1次,共6次,进行围术期镇痛;对照组30例使用静脉镇痛泵镇痛,药液为芬太尼混合液。2组均在术后24、48、72h用VAS评分评价疼痛程度,在术前、术后即刻和48h测定血清中COX-2和人前列腺素E(PGE2)。结果 2组的VAS评分在术后24h和48h具有统计学差异(P<0.05)。术前2组血清COX-2和PGE2差异无统计学意义(P>0.05);试验组术后即刻血清COX-2和PGE2均下降,但与术前对比无统计学意义(P>0.05);术后48h血清COX-2和PGE2均下降,且与术后即刻对比较差异有统计学意义(P<0.05或P<0.01);对照组术后即刻血清COX-2和PGE2均升高,而且PGE2浓度术后即刻与术前对比差异有统计学意义(P<0.05);术后48h血清COX-2和PGE2均较术后即刻下降,但术后48h与术后即刻血清COX-2比较差异无统计学意义(P>0.05);而血清PGE2浓度差异有统计学意义(P<0.01);术后即刻2组血清PGE2浓度差异有统计学意义(P<0.05),术后48hCOX-2和PGE2差异均有统计学意义(P<0.05)。结论围术期使用赛来昔布和帕瑞昔布钠具有较强的镇痛作用。

Objective To observe the effect of celecoxib and parecoxib on perioperative analgesia.Methods 72 cases patients were randomly divided into experimental group（42 cases） and control group（30 cases） .Experimental group were given celecoxib and parecoxib,celecoxib 400mg two hours before the operation and received intramuscular injection of parecoxib 40mg immediately after the operation and following q12h with a total of six times.Control group used intravenous analgesia.VAS score was measured at 24,48 and 72h after surgery.The contents of COX-2 and PGE2 in the serum were measured before the operation、at the end of the operation and 48h after the operation.Results VAS score after 24h and 48h of 2 group was significant difference（P 0.05） .Compared the levels of COX-2 and PGE2 of 2 groups in preoperative,there had significant difference（P 0.05）;After immediately serum COX-2 and PGE2 of experimental group decreased,but compared with preoperative,there had no significant difference（P 0.05）;After 48h of serum COX-2 and PGE2 decreased,and compared with the immediate postoperative period,there had a significant difference（P 0.05 or P 0.01）;The serum instantly COX-2 and PGE2 of control group were increased,and PGE2 concentration compared with after preoperative immediately,there had a significant difference（P 0.05）;After 48h of serum COX-2 and PGE2 was downer than after immediately;The serum PGE2 concentration was significantly（P 0.01）;After perioperation the concentration of serum PGE2 of 2 groups had significantly difference（P 0.05）,after perioperation differences of 48h COX-2 and PGE2 were statistically significant（P 0.05） .Conclusion Celecoxib and parecoxib have a strong analgesic effect for the perioperative analgesia.