帕瑞昔布钠超前镇痛在胸腔镜肺大疱切除术中的应用

Application of parecoxib sodium for preemptive analgesia in patients undergoing thoracoscopic bullectomy

目的探讨帕瑞昔布钠超前镇痛对胸腔镜肺大疱切除术后疼痛的影响。方法 130例双腔气管插管全麻下行肺大疱切除术患者,按随机数字表法分为对照组和观察组各65例,观察组患者于术前15min静脉注射40mg帕瑞昔布钠,而对照组患者则静脉注射2ml生理盐水。采用视觉模拟评分法(VAS)分别于术后1h、2h、4h、8h和12h评估患者疼痛程度,记录患者恶心呕吐、呼吸抑制、皮肤瘙痒和尿潴留等不良反应。结果与对照组患者比较,观察组各个时段VAS评分明显降低(P<0.05),观察组镇痛的满意率明显升高(P<0.05),观察组患者在恶心呕吐、皮肤瘙痒及尿潴留的发生率差异无统计学意义(P>0.05)。结论胸腔镜肺大疱切除术患者手术前静注帕瑞昔布钠超前镇痛效果确切,满意度高,无增加恶心呕吐、皮肤瘙痒及尿潴留副作用。

Objective To investigate the preemptive analgesia effect ofparecoxib sodium after thoracoscopie bullectomy. Methods One hundred and thirty patients undergoing thoracoscopic bullectomy under double-lumen endotracheal intubation were divided into the control group and the observation group, according to random number table. The observation group （n=65） were given 40 mg parecoxib sodium intravenously 15 min before operation, while patients in the control group （n=65） were given 2 ml normal saline intravenously. Visual analogue scale （VAS） were applied to assess the degree of pain in patients 1 h, 2 h, 4 h, 8 h and 12 h after operation. Adverse reactions were recorded, including nausea and vomiting, respiratory depression, itchy skin, and urinary retention. Results Compared with the control group, the observation group had significantly lower VAS scores （P〈0.05） and significantly higher an- algesia satisfaction rate （P〈0.05）. The two groups showed no statistically significant difference in the incidence of nausea and vomiting, itchy skin and urinary retention （P〉0.05）. Conclusion Application ofparecoxib sodium before thoracoscopic bullectomy shows good preemptive analgesia effect, which results in greater patient satisfaction and no higher incidence of adverse reactions such as nausea and vomiting, itchy skin and urinary retention.