帕瑞昔布钠对上腹部手术术后舒芬太尼静脉镇痛效果的影响

Effects of Parecoxib Sodium on Sufentanil Intravenous Analgesia after Upper Abdominal Operation

目的探讨帕瑞昔布钠应用于上腹部手术后舒芬太尼静脉自控镇痛(PCIA)效果的影响。方法选择80例ASAⅠ～Ⅱ级全麻下行上腹部手术患者,分为A组帕瑞昔布钠组,B组生理盐水组。于术毕前半小时A组静脉推注帕瑞昔布钠40 mg(用生理盐水稀释成2 mL),B组静脉推注生理盐水2mL,术毕即开始进行舒芬太尼PCIA。用视觉模拟评分法(VAS)观察两组患者术后2 d内各时点的镇痛效果;同时记录48 h舒芬总用量以及需哌替啶镇痛患者例数;平均自控镇痛(PCA)总按压次数和有效次数;记录患者满意度;两组患者术后不良反应的发生率。结果 A组患者术后1、2、4、8、12 h VAS评分低于B组;舒芬太尼用量以及PCA总按压次数及有效按压次数A组均少于B组,需哌替啶镇痛的患者数A组亦少于B组;B组恶心、呕吐发生率高于A组。结论帕瑞昔布钠联合舒芬太尼PCIA用于上腹部手术的术后镇痛安全、有效,值得在临床推广应用。

Objective To discuss the effect of parecoxib sodium on sufentanil intravenous analgesia after upper abdominal operation.Methods 80 cases of ASA Ⅰ-Ⅱ abdominal operation patients were divided into group A（parecoxib group） and group B（saline group）.In half an hour before the operation,group A was intravenously injected parecoxib sodium 40 mg（diluted with saline into 2 mL）,group B was intravenously injected saline 2 mL.All patients began sufentanil intravenous analgesia at the end of operation.We observed the visual analog scale（VAS） grade of the two groups′ patients in several time points in 2 days after operation,the total dosage of sufentanil and the patient numbers who needed analgesia with dolantin,the average click times and effective times,the satisfaction of patients and the incidence of untoward effect of the two groups were recorded.Results Group A VAS grades after operation were lower than B group at 1,2,4,8 and 12h;and the dosage of sufentanil,the total click times of PCA and the effective times,the number of patients who need dolandin,nausea and vomiting incidence of group A were also lower than group B.Conclusion Using parecoxib sodium in combination with sufentanil intravenous analgesia after upper abdominal operation is safe and effective,worth of popularization in clinic.