帕瑞昔布钠与氟比洛芬酯在腹腔镜胆囊切除术后的镇痛效应

Effects of parecoxib and flurbiprofen injection on postoperative pain relief after laparoscopic cholecystectomy

目的比较帕瑞昔布钠与氟比洛芬酯在腹腔镜胆囊切除术后的镇痛效应。方法选择行择期腹腔镜胆囊切除术患者90例,ASAⅠ或Ⅱ级,年龄>18岁,随机分为三组(n=30):P0为对照组,患者麻醉诱导前未使用帕瑞昔布钠或氟比洛芬酯;P1组,患者麻醉诱导前静脉予帕瑞昔布钠40mg;P2组,患者麻醉诱导前静脉予氟比洛芬酯50mg。所有患者均行常规麻醉诱导,采用视觉模拟评分,观察术后2、4、8、12、24h疼痛评分。结果 P1、P2组在术后2、4、6、12、24h的VAS评分都低于P0组,差异有统计学意义(t分别=4.48、-4.78、5.76、5.39、3.81、2.97、5.04、4.09、4.71、5.04,P均<0.05),P1、P2组在术后各个时间点VAS评分比较,差异均无统计学意义(t分别=0.57、-5.71、-1.14、-1.79、0.33,P均>0.05);三组应用吗啡用药病例数及24h内需要更换敷料的病例数比较,差异均无统计学意义(χ2分别=3.03、0.58,P均>0.05)。结论帕瑞昔布钠40mg,氟比洛芬酯50mg静脉注射均可以减轻腹腔镜胆囊切除术后疼痛,减少术后24h内吗啡用药。

Objective To compare the analgesia efficacy of parecoxib and flurbiprofen injection on postoperative pain relief after laparoscopic cholecystectomy.Methods A total of 90 patients aged above 18-year undergoing selective laparoscopic cholecystectomy were randomly divided into 3 groups（n=30）：P0 group（control group） did not receive intravenous parecoxib or flurbiprofen;P1 group received intravenous parecoxib;P2 group received intravenous flurbiprofen.Tracheal intubation was performed after introduction.The degree of the postoperative pain was assessed 2,4,6,12,24 hours in the first 24 hours after surgery using a Visual Analog Scale（VAS）.Results Postoperative pain scores were less in the P1 and P2 groups than that in the P0 group 2,4,6,12,24 hours（t=4.48,-4.78,5.76,5.39,3.81,2.97,5.04,4.09,4.71,5.04,P0.05）after surgery.There were no significant differences between the P1 and P2 groups at any time（t=0.57,-5.71,-1.14,-1.79,0.33,P0.05）.The cumulative use of morphine and dressing changing cases had no significant differences（χ2=3.03,0.58,P0.05）.Conclusions Intravenous parecoxib 40 mg or flurbiprofen 50 mg were effective in decreasing the VAS and reducing the cumulative use of morphine in the first 24 hours.