帕瑞昔布钠在经皮肝穿刺射频消融术麻醉中的应用

Application of parecoxib injection in total intravenous anesthesia for percutaneous radiofrequency ablation

目的探讨经皮肝穿刺射频消融术中应用帕瑞昔布钠是否可以减少静脉麻醉药的用量,从而减少不良反应的发生。方法选择需行PRFA治疗的肝癌患者60例,随机分为P组和N组,每组30例,其中P组术前15min静脉注射帕瑞昔布钠40mg,N组术前15min静脉注射生理盐水5ml,两组患者术中都予瑞芬太尼复合异丙酚静脉泵入维持麻醉。记录术前及术中患者的平均动脉压(MAP)、心率(HR)、脉搏氧饱和度(SpO2)及呼吸频率(RR);记录手术时间、患者苏醒时间及静脉麻醉药的用量;观察术中出现体动、呼吸抑制的发生情况。结果瑞芬太尼用量P组显著少于N组(P<0.05),术中体动及呼吸抑制的发生率P组均少于N组,差异有统计学意义(P<0.05)。结论帕瑞昔布钠可以减少肝癌射频术中瑞芬太尼的用量,降低呼吸抑制等副作用的发生率。

Objective To observe if parecoxib injection used in percutaneous radiofrequency ablation（PRFA） can reduce the amount of anesthetic and obvious side effects.Methods 60 patients scheduled for PRFA were divided randomly into two groups.Group P received parecoxib injection at the dose of 50 mg 15 min before PRFA,and group N were given normal saline 5 mL at the same time.The two groups were given continuously intravenous infusion of remifentanil combined with propofol by micro pump.The mean arterial pressure,heart rate,pulse oxygen saturation,respiratory rate were recorded.Body movements and respiratory depression were compared during operation.Results The total consumption of remifentanil in group P was less than that in group N（P〈0.05）.Patients had less body movement and less respiratory depression reaction in group P than that in group N（P〈0.05）.Conclusion Parecoxib injection can reduce the consumption of remifentanil and the reaction of respiratory depression in anesthesia for PRFA.