帕瑞昔布钠超前镇痛用于腹腔镜胆囊切除术的临床效果评价

The efficacy and safety of intravenous parecoxib analgesia for laparoscopic cholecystectomy

目的评价静脉注射帕瑞昔布钠超前镇痛用于腹腔镜胆囊切除术的效果与安全性。方法对60例ASAI～Ⅱ级,择期行腹腔镜胆囊切除术的患者随机分为2组:曲马多组(Ⅰ组,n=30),术前30分钟静脉注射200mg曲马多;帕瑞昔布钠组(Ⅱ组,n=30),术前30分钟静脉注射40mg帕瑞昔布纳(特耐)。分别于术后4、8、12、16、20、24h观察BP、HR、疼痛评分VAS(视觉模拟评分法)、Prince Henry评分(PHS)、Ramsay镇静评分及恶心、呕吐、瘙痒、尿潴留等不良反应。结果 VAS、PHS评分两组患者无显著性差异(P>0.05);Ramsay镇静评分在4、8、12h时,Ⅰ组高于Ⅱ组;恶心呕吐、瘙痒、眩晕的发生率Ⅰ组高于Ⅱ组。结论帕瑞昔布钠用于腹腔镜胆囊切除术的患者能够获得与曲马多相同的镇痛效果,无过度镇静情况发生,对患者更安全,且恶心呕吐、眩晕的发生率低,具有临床推广应用价值。

Objective To evaluate the efficacy and safety of intravenous parecoxib analgesia for laparoscopic cholecystectomy.Methods 60 patients ASA Ⅰ~Ⅱ grade aged（20）^（56） undergoing laparoscopic cholecystectomy were randomly divided into two groups（n=30）： Group I,the tramadol group and group 2,the parecoxib group.The tramadol group were given a bolus of 200mg tramadol 30 minutes before operation while the parecoxib group were given abolus of 40mg parecoxib 30 minutes before operation.The blood pressure,heart rate,pain scores VAS（visual analog scale）,Prince Henry score（PHS）,Ramsay sedation score,nausea,vomiting,itching,urinary retention and other adverse reactions were recorded in 4,8,12,16,20 and 24 hour postoperation respectively.Results There were no significant differences of the VAS and PHS score between the two groups.In group I,Ramsay sedation score were higher group Ⅱ at the 4 hour postoperation and 8 hour postoperation and 12 hour postoperation.The complaint of nausea,vomiting and dizziness in group I were higher than group Ⅱ.Conclusion There were no differences in analgesic effect between tramadol and parecoxib during laparoscopic cholecystectomy.parecoxib was safer in analgesia without excessive sedation and lower nausea and vomiting and dizziness during laparoscopic cholecystectomy.