宫腹腔镜联合检查患者应用帕瑞昔布钠的镇痛效果和满意度

Efficacy of parecoxib on pain management and patients′ satisfactory after diagnostic hysteroscopy and laparoscopy

目的评价宫腹腔镜联合检查患者术前用帕瑞昔布钠的镇痛效果和满意度。方法随机双盲、安慰剂对照试验,60例择期全麻下行宫腹腔镜联合检查患者随机分为帕瑞昔布组(D组)和生理盐水组(S组),各30例。麻醉诱导后、手术开始前静脉给予帕瑞昔布钠40 mg(D组)或等量生理盐水(S组)。术后记录停药后患者苏醒时间、睁眼时间和定向力恢复时间,记录患者在恢复室内的疼痛评分和术后6,24 h疼痛评分以及患者满意度。结果 2组患者的麻醉恢复时间和质量无显著性差异。与S组相比,D组患者24 h内最严重疼痛(3.9±3.8vs 5.6±4.6)和最轻微的疼痛程度(0.5±1.4 vs 1.4±1.8)较低,术后6,24 h差异无统计学意义,D组术后患者对疼痛治疗更为满意。结论术前用帕瑞昔布钠可有效控制宫腹腔镜联合检查患者的术后疼痛,显著提高患者的满意度。

Objective To assess the effect of preoperative administration of parecoxib on anesthesia recovery, pain management and patients＇ sat- isfactory after diagnostic hysteroscopy and laparoscopy. Methods Sixty patients undergoing elective diagnostic hysteroscopy and laparoscopy, were enrolled in the randomized, placebo - controlled, double - blind tri- al. After anesthesia induction, patients were randomly assigned to receive 40 mg of intravenous parecoxib （ group D ; n = 30） or an equal volume of saline （group S; n = 30）. Assessments included recovery time to eye opening, response to commands and orientation. Postoperative outcomes included postoperative analgesic consumption and pain scores, occur- rence of nausea and vomiting and patient satisfaction. Antiemetic require- ments and adverse effects were noted during the first postoperative 24 h. Results The most serious and most slight pain scores were significantly lower in the parecoxib group compared with those of the placebo group during the first postoperative 24 h （3.9 ± 3.8 vs 5.6 ± 4.6, P 〈 0. 05, and 0. 5 ± 1.4 vs 1.4 ± 1.8, P 〈 0. 05）. The number of patients receiv- ing tramadol （6 versus 1, P 〈 0. 05 ） was greater in group S than that in group D. There were no differences between the two groups in recovery time, antiemetic requirements, or adverse effects after surgery. Overall satisfaction with pain management was higher in parecoxib - treated pa- tients. Conclusion Perioperative use of parecoxib provides a significantanalgesic benefit in patients undergoing diagnostic hysteroscopy and laparoscopy.