帕瑞昔布钠联合芬太尼在腰椎孔镜下髓核摘除术中的应用

Parecoxib sodium combined fentanyl in the patients undergoing transforaminal endoscopic discectomy surgery

目的观察帕瑞昔布钠联合小剂量芬太尼在腰椎孔镜下髓核摘除术中的镇痛效果。方法选择该院行椎间孔镜下髓核摘除、射频热凝纤维环成形术患者34例,随机分为帕瑞昔布钠联合芬太尼组(PF组n=17例)和芬太尼组(F组n=17例)。PF组:帕瑞昔布钠40 mg+芬太尼0.05 mg;F组:芬太尼0.05 mg。两组均用生理盐水稀释成5 ml在局麻开始前15 min静注。两组都采用1%的利多卡因作为局麻药。结果 T2～T5时点PF组的VAS评分、MAP和HR值低于F组(P<0.05);PF组术中芬太尼的追加剂量少于F组(P<0.05);T6时点两组患者的MAP、HR及VAS无差异(P>0.05)。结论椎间孔镜下髓核摘除术中,帕瑞昔布钠联合小剂量芬太尼具有良好的镇痛效果,且可减少术中芬太尼的用量。

Objective To investigate the analgesic effects of parecoxib sodium combined the small dose of fentanyl in the patients undergoing transforaminal endoscopic discectomy surgery.Methods Thirty-four patients aged 33~68 yr,ASAⅠorⅡ,undergoing transforaminal endoscopic discectomy and radiofrequency thermal annuloplasty in the treatment of discogenic low back pain were randomly divided into two groups：group PF（parecoxib 40 mg plus 0.05 mg fentanyl） and group F（fentanyl 0.05 mg）.The two groups all used the normal saline diluted to 5 ml to iv 15 minutes before the start of local anesthesia.For the two groups local anaesthetics were 1% lidocaine.Results The VAS score,MAP and HR at T2~T5 were significantly lower in group PF than those in group F（P0.05）.Group PF was also the least to consume fentanyl during operation in two groups.At the time of T6 the patients of MAP,HR and VAS in two groups had no difference.Conclusion Parecoxib combined fentanyl can provide good analgesia and reduces fentanyl consumption in patients during transforaminal endoscopic discectomy surgery.