帕瑞昔布在膝关节镜术后镇痛中的应用

Application of parecoxib for postoperative analgesia in arthroscopic surgery of the knee

目的:探讨帕瑞昔布短期应用对膝关节镜手术患者术后镇痛的影响。方法:60例择期膝关节镜前交叉韧带重建术患者,ASAⅠ～Ⅱ级,年龄18～50岁,体重指数均在正常范围。随机分为3组:安慰剂组(Ⅰ组)、术前帕瑞昔布组(Ⅱ组)和术后帕瑞昔布组(Ⅲ组)。采用VAS评分测定静注帕瑞昔布后2,61,2和24 h时疼痛程度,并记录各时间点不良反应情况,以及患者对镇痛的总体满意度。结果:与Ⅰ组相比,Ⅱ、Ⅲ组术后61,2,24 h VAS评分降低,术后使用镇痛药例数显著减少,术后24 h患者满意度明显提高,不良反应发生率降低;而Ⅱ组在术后6和12 h时VAS评分较Ⅲ组低(P<0.05)。结论:静脉给予帕瑞昔布钠40 mg可减轻患者膝关节镜手术后疼痛,降低不良反应发生率,提高术后镇痛质量,术前使用较术后使用效果更佳。

Objective：To investigate effectiveness of parecoxib sodium for postoperative analgesia in arthroscopic surgery of the knee.Methods：In 60 patients（ASA I or II,aged 18~50 yr,scheduled for elective arthroscopic surgery of the knee） were randomly divided into three groups（n=20 for each group）.Patients were intravenously injected with parecoxib sodium 40 mg before or at the end of surgery,or with equivalence saline（control）.The intensity of pain was evaluated using VAS score（0~10,0=no pain,10=worst pain） at 2,6,12,24 h after operation.The adverse effects,the needs of postoperative analgesic drugs and the patients＇ global evaluation of the postoperative analgesia were recorded and compared 24 h after the operation.Results：As compared with control,parecoxib administered both before and after surgery significantly reduced the needs of postoperative analgesic drugs at 24 h,the VAS scores after operation,and the adverse effects（P0.05）.Meanwhile,the patients in both parecoxib groups were more satisfied for the postoperative analgesia than those in control group（P0.05）.The VAS scores at 6,12 h after operation were significantly less when parecoxib was injected at the end of surgery.Conclusion：Intravenous parecoxib sodium（40 mg） has a potent analgesic effect,reduces the percentage of adverse effects,and improves postoperative analgesic effect.Pre-operative application of parecoxib may be more effective.