帕瑞昔布钠超前镇痛用于显微支撑喉镜下成人声带息肉摘除术的临床观察

Observation on parecoxib preemptive analgesia for adult vocal cord polyp excision by micro-suspension laryngoscope

目的探讨帕瑞昔布钠超前镇痛用于成人显微支撑喉镜下声带息肉摘除术的镇痛效果和安全性。方法将68例择期行声带息肉摘除术的患者随机分为帕瑞昔布钠组(P组,n=34)和0.9%的氯化钠注射液对照组(C组,n=34),P组于麻醉诱导前缓慢静注帕瑞昔布钠40mg(用0.9%的氯化钠注射液稀释至10ml),C组以0.9%的氯化钠注射液10ml缓慢静注。采用视觉模拟评分法(VAS)评价患者术后1、2、4、8、12、24h疼痛程度,同时观察恶心呕吐、呼吸抑制及凝血功能异常等不良反应的发生情况。结果 P组术后各时点VAS评分均明显低于C组,差异均有统计学意义(t分别=8.49、8.90、8.44、7.33、7.88、6.12,P均<0.05)。两组各时点均无明显呼吸抑制及凝血功能异常,两组术后恶心呕吐发生率差异无统计学意义(χ2=0.09,P>0.05)。结论帕瑞昔布钠超前镇痛可减轻成人显微支撑喉镜下声带息肉摘除术后疼痛,且无明显不良反应,可安全用于术后镇痛。

Objective To study effect and safety of parecoxib sodium preemptive analgesia applying in adult vocal cord polyp excision by micro-suspension laryngoscope.Methods A total of 68 cases of such patients randomly divided into parecoxib sodium group（P group,n=34）and 0.9% sodium chloride injection control group（C group,n=34）.Group P was given 40 mg parecoxib sodium（with 0.9% sodium chloride injection diluted to 10 ml） before induction of anesthesia;C group was given 10 ml 0.9% sodium chloride injection.The analgesic effect assessed by visual analogue scale（VAS） at 1,2,4,8,12,24 hours postoperation,and respiratory depression,nausea and vomiting,coagulation abnormalities were observed at the same time.Results Compared with the group C,VAS score in group P were significantly lower at each time,and there were statistical significances between group C and group P（t=8.49,8.90,8.44,7.33,7.88,6.12,P 0.05）.There were no respiratory depression and coagulation abnormalities occurred at all time points,while there were no statistical significance between group C and group P in the incidence of adverse reactions such as nausea and vomiting（χ2=0.09,P0.05）.Conclusions Parecoxib sodium preemptive analgesia might reduce acute postoperative pain induced by the micro-suspension laryngoscope effectively after adult vocal cord polyp resection.It has no obvious side effects and can be safely used for postoperative analgesia.