地塞米松、帕瑞昔布钠对支撑喉镜喉显微术后镇痛疗效比较

Comparison of the reduced postoperative sore throat after laryngeal microsurgery by dexamethasone and parecoxib sodium

目的比较单次注射地塞米松、帕瑞昔布钠用于减轻支撑喉镜喉显微手术后咽喉痛的效果。方法全麻下支撑喉镜喉显微手术165例,随机分为3组。D组于麻醉诱导前静脉注射地塞米松7.5mg,P组注射帕瑞昔布钠40mg,C组注射生理盐水10ml。于术后2、10、24h进行随访,记录咽喉痛的VAS评分。结果术后2h和10h,D、P组VAS评分均明显低于C组(P﹤0.01)。术后24h,D组VAS评分显著低于P组与C组,有显著性差异(P﹤0.01);而P组评分与C组相当。结论单次注射地塞米松、帕瑞昔布钠均能减轻支撑喉镜喉显微手术后咽喉痛,前者作用时效更长。地塞米松因其抗炎、抗水肿作用可能更适用于减轻支撑喉镜喉显微手术后咽喉痛。

Objective To compare the effect of dexamethasone or parecoxib sodium in reducing postoperative sore throat after laryngeal microsurgery.Methods A total of 165 patients scheduled for laryngeal microsurgery under general anesthesia were randomly divided into 3 groups.Dexamethasone 7.5mg （Group D）,parecoxib sodium 40mg（Group P）,or normal saline （Group C） were injected before the induction of anesthesia.Patients were followed up at 2h,10h,and 24h after the surgery.The general VAS score as the end point of postoperative sore throat was measured for each patient by averaging the VAS scores during resting and swallowing.Results Two hours and 10 hours after surgery,the general VAS scores were significantly lower in Group D and Group P compared with Group C.Twenty-four hours after surgery,the general VAS scores were significantly lower in Group D compared with Group P and Group C while the general VAS scores were comparable between Group P and Group C.Conclusions Single injection of dexamethasone,parecoxib sodium can reduce the severity of sore throat after laryngeal microsurgery while the analgesic effect of dexamethasone for sore throat persistentsfor longer duration.Dexamethasone may be more appropriate for postoperative analgesia after laryngeal microsurgery by its anti-inflammatory and anti-edema effects.