帕瑞昔布钠联合术后自控镇痛在上腹部手术患者的临床应用

Clinical application of parecoxib sodium combined with postoperative patient-controlled analgesia to patients undergoing upper abdominal operation

目的观察帕瑞昔布钠联合静脉自控镇痛对上腹部手术患者术后的镇痛疗效。方法 78例上腹部手术患者,年龄23～68(58±12)岁,随机均分为A、B组。两组均以丙泊酚、芬太尼、维库溴铵诱导插管,丙泊酚、瑞芬太尼持续泵注并持续吸入七氟醚维持麻醉。A组于手术结束前30 min静注帕瑞昔布钠40 mg,B组注射生理盐水2 ml作为空白对照。两组均以芬太尼(总量0.8～1.0 mg)实施患者自控镇痛(PCA)。记录患者术后2 h疼痛视觉模拟评分(VAS)及24 h的PCA有效按压次数。结果 A组术后2 h VAS评分及24 h的PCA按压次数均低于B组(P<0.05)。结论上腹部手术患者手术结束前静注帕瑞昔布钠40 mg可有效减轻术后疼痛,并减少术后芬太尼的用量。

Objective To evaluate the postoperative analgesic effects of parecoxib sodium combined with patient-controlled analgesia（PCA）in patients undergoing upper abdominal operation.Methods 78 patients undergoing upper abdomen surgery were randomly divided into group A and group B.All patients were administered propofol and vecuronium via intubation for the induction of anesthesia,and then propofol and remifentanil were incessantly pumped into veins combined with the continuous inhalation of sevoflurane for maintenance anesthesia.Group A were injected with sodium parecoxib of 40 mg and group B with normal saline of 2 ml as the placebo 30 min before the end of operation.Fentanyl totaling 0.8-1.0 mg in both groups was used for PCA after operation.Visual analogue scales（VAS）2 h after operation and the effective press number of PCA within 24 h were recorded.Results Both VAS 2 h after operation and the effective press number of PCA within 24 h were lower in group A than those in group B（P0.05）.Conclusion The injection of parecoxib sodium before the end of upper abdominal operation can effectively reduce patients＇ postoperative pain and lower postoperative fentanyl consuming.