帕瑞昔布钠对宫颈锥切患者镇痛作用的效果

Analgesic Effect of Parecoxib Sodium in Conization of Cervix of Gynecologic Outpatients

目的:观察帕瑞昔布钠(PS)在门诊妇科宫颈锥切手术中的应用效果。方法:选取ASA I或II级,宫颈锥切手术患者40例。随机分为对照组、PS组(40 mg),每组20例。PS组和对照组患者于术前30 min分别静脉注射PS 40mg和0.9%氯化钠注射液2mL。芬太尼1μg.kg-1、异丙酚2 mg.kg-1诱导,并以4 mg.kg-1.h-1异丙酚维持麻醉。记录术中体动次数、呼吸抑制次数、异丙酚总用量、术后30 min Ramsay镇静评分、术后30 min、1 h和8 h的VAS镇痛评分。结果:PS组术中体动次数、呼吸抑制次数、异丙酚总用量均较对照组减少(P<0.05);两组患者术后30 min Ramsay评分无显著统计学差异(P>0.05);PS组术后30 min、1 h和8 h的VAS评分与对照组相比明显下降(P<0.01)。结论:术前静注帕瑞昔布钠能减轻宫颈锥切术患者的术中及术后疼痛,减少术中异丙酚用量,降低麻醉风险。

Objective： To observe the analgesic effect of preoperative parecoxib sodium（PS） in outpatients undergoing gynecologic conization of cervix.Methods： Forty,ASA I or II patients undergoing conization of cervix randomly received intravenous PS 40 mg（PS group） or the same volume of saline（control group）,respectively,30 min before operation.All patients received intravenous fentanyl and propofol for induction.Anesthesia was maintained with propofol 4 mg·kg-1·h-1.Numbers of body-movement,respiratory depression and consumption of propofol were recorded during operation.Ramsay Scores were recorded 30 min after operation,and Visual Analogue Scores（VAS） 30 min,1 h and 8 h after operation were also recorded.Results： Compared with control group,the numbers of body-movement,respiratory depression and consumption of propofol were significantly deceased in PS groups during operation（P0.05）.There were no statistical differences of Ramsay Scores between the two groups.Nevertheless,VAS scores in PS groups at 30 min,1 h and 8 h after operation were lower than those in control group（P0.01）.Conclusion： PS can make the patients undergoing conization of cervix experience less pain.Also,it can reduce the consumption propofol and the risk of anesthesia.