帕瑞昔布钠复合吗啡对腹部手术患者自控镇痛及呼吸功能的影响

Effects of analgesia with parecoxib combined morphine on patient controlled analgesia and pulmonary function in patients after abdominal opertion

目的:观察帕瑞昔布钠复合吗啡对拟行腹部手术患者自控镇痛及呼吸功能的影响。方法:将50例拟行腹部手术患者随机分为帕瑞昔布钠组(P组)和吗啡组(M组),每组25例。PCA泵的镇痛药为吗啡1 mg/mL,应用PCA泵的同时,P组静脉注射首剂帕瑞昔布钠40 mg,首剂药物后12、24和36 h,静脉注射帕瑞昔布钠40 mg;M组在4时间点均注射生理盐水。镇痛开始后12、24、36和48 h记录疼痛VAS评分及镇静程度评分;PCA需求按压次数、有效按压次数及药物用量;术后各种并发症及不良反应发生率;术后24、48和72 h呼吸功能指标。结果:P组患者各时间点安静痛和咳嗽痛评分显著低于M组(P<0.05);镇静程度评分、PCA需求按压次数、有效按压次数及药物用量P组显著低于M组(P<0.05);P组恶心发生率显著低于M组(P<0.05);P组术后24、48 h的FVC%和FEV1%明显高于M组(P<0.05),术后24 h动脉血二氧化碳分压(PaCO2)明显低于M组(P<0.05)。结论:帕瑞昔布钠可安全有效地应用于拟行腹部手术患者自控镇痛,可减少吗啡用量并有利于呼吸功能恢复。

AIM： To investigate effects of an-algesia with parecoxib combined morphine on patient controlled analgesia and pulmonary func tion in patients after abdominal opertion. METHODS： Fifty patients were randomly alloca-ted to Parecoxib group （group P, n=25） and Morphine group （group M, n=25）. Both groupreceived PCA with morphine （1 mg/mL） Group P received intravenous parecoxib 40 mg while the PCA pump beginning, 12,24 and 48 h after the first dose. Group M received intrave-nous normal saline at the same four point. The following indexes were recorded at 12, 24, 36 and 48 hours after the PCA pumps were used：VAS scores of pain, sedation score, demanded delivery, effective delivery, drug dose, and side effects. To compare parameters of pulmonary function in postoperative 24, 48 and 72 h be-tween the two groups. RESULTS. Compared with group M , there were significant decreases in VAS scores of pain at 12, 24, 36 and 48 hours after the PCA pumps were used（P〈0.05）. Se-dation score, demanded delivery, effective deliv-ery and drug dose in group P were obviously lower than those in group M（P〈0.05）. The in-cidence rate of nausea in group P was obviously lower than that in group M（P〈0.05）. FVC% and FEV1% were significantly higher in postop-erative 24 and 48 h in treatment group than those in control group （P（0.05）. PaCO2 were significantly lower in postoperative 24 h in treat-ment group than that in control group （P〈0.05）. CONCLUSION： Parecoxib can relief painin patient after abdominal opertion safely and ef ficiently, reduce the morphine consumption and improve pulmonary function.