腹腔镜胆囊切除术前应用帕瑞昔布对术后镇痛的影响

Pre-emptive analgesic effect of parecoxib in laparoscopic cholecystectomy

目的观察帕瑞昔布在腹腔镜胆囊切除术(LC)术前应用对术后镇痛的影响。方法择期全麻LC患者60例,随机均分为三组:A组术前30～45min静注帕瑞昔布40mg,B组手术结束关腹时静注帕瑞昔布40mg,C组麻醉诱导时静注曲马多100mg。记录患者术后安静时疼痛VAS评分,并观察恢复情况。结果 A组清醒后即刻疼痛VAS评分显著高于B、C两组(P<0.05)。A、B组排气时间显著短于C组(P<0.05)。B组下床时间显著短于A组(P<0.05),进食时间明显短于C组(P<0.05)。A、B组不良反应显著少于C组(P<0.05)。结论术前应用帕瑞昔布40mg对LC未显示出超前镇痛作用,术后应用帕瑞昔布与曲马多超前应用镇痛效果相当,不良反应减少。

Objective To observe whether parecoxib administered in laparoscopic cholecystectomy （LC） could play a role of preemptive analgesia. Methods Sixty patients scheduled for LC were divided into three groups, the which IV dosing schedules as following： parecoxib 40 mg 30-45 rain before the surgery（group A） ; parecoxib 40 mg at wound closure（group B） ; tramadol 100 mg at induction（group C）. Pain scores and recovery station were recorded. Results Higher pain scores were observed in group A than in group 13 and group C at 0 h （P（0. 05） ; side-effcets in group A and group B were significantly reduced compared with the group C（P〈0. 05）. Condusion Parecoxib is lack of pre-emptive analgesic effect in LC, postoperative administration of parecoxib have the same analgesic effect with preemptive use of tramadol, but less adverse reactions.