帕瑞昔布钠对周围血管患者术后止痛作用的疗效观察

Efficacy Observation of Parecoxib Sodium on the Postoperative Analgesia for the Patients with Peripheral Vascular Surgery

目的观察帕瑞昔布钠治疗周围血管患者术后疼痛的有效性。方法择期行大隐静脉高位结扎剥脱术的患者120例,年龄40～60岁,ASAⅠ～Ⅱ级,随机分为帕瑞昔布钠组和对照组,每组60例。两组患者均选择连续硬膜外麻醉,帕瑞昔布钠组在硬膜外穿刺前经静脉给予帕瑞昔布钠40 mg,间隔12 h再次静脉给予帕瑞昔布钠40 mg,对照组给予等量生理盐水。记录患者术后12 h和24 h的VAS评分,两组患者均在要求术后止痛时,先行VAS评分,3分以上的给予杜冷丁1 mg.kg-1,记录术后12 h和24 h两组患者的VAS评分,两组患者术后需要辅助镇痛发热的例数,以及观察期间恶心呕吐等不良反应的发生情况。结果两组比较,帕瑞昔布钠组12 h和24 h VAS评分均低于对照组,仅12 h点两组VAS评分差异有统计学意义(P<0.05)。帕瑞昔布钠组无术后辅助镇痛的患者,3例发生术后恶心呕吐,而对照组在术后辅助镇痛的发生率和恶心呕吐的发生率上都远远高于帕瑞昔布钠组,差异均有统计学意义(P<0.05)。结论帕瑞昔布钠用于周围血管手术患者术后镇痛效果确切,不良反应少,具有广泛的运用前景。

Objective To observe the effectiveness of parecoxib sodium on the postoperative pain for the patients with peripheral vascular surgery.Methods 120 patients for the surgery of high ligation and stripping of great saphenous vein on an elective day,aged 40 to 60 years,ASA Ⅰ to Ⅱ grade,were randomized into a parecoxib sodium group and a control group,60 cases in each one.The continuous epidural anesthesia was selected in either group.In parecoxib sodium group,before the epidural puncture,parecoxib sodium was administered intravenously,40mg,and repeated once again after 12 h.In control group,the physiological saline of the same dose was used.VAS was recorded in 12 h and 24 h separately after surgery.VAS was conducted at first when requiring the postoperative analgesia in either group.For those with VAS over 3 scores,pethidine,1 mg·kg-1 was given.VAS was recorded in 12 h and 24 h after surgery separately in either group,as well as the cases requiring adjuvant analgesia after surgery.Additionally,the adverse reactions such as nausea and vomiting were observed during the surgery.Results In comparison,VAS in 12 h and 24 h in parecoxib sodium group was all lower than those in control group.The VAS difference at 12 h time-point was significant between two groups（P0.05）.In parecoxib sodium group,the adjuvant analgesia was not required after surgery,but 3 cases presented postoperatively nausea and vomiting.In control group,the occurrence rates of either postoperative adjuvant analgesia or nausea and vomiting were much higher than those in parecoxib sodium group,indicating statistical significance（P0.05）.Conclusion Parecoxib sodium has a definite effect on the postoperative analgesia for the patients with peripheral vascular surgery and has less adverse reactions.Hence,it is prospective to be applied extensively.