帕瑞昔布和塞来昔布在脊柱融合术后镇痛效果比较

Analgesic effect of parecoxib sodiuml and celecoxib after lumbar fusion surgery

目的比较塞来昔布和帕瑞昔布在腰椎融合术后的镇痛效果。方法 120例腰椎融合术患者随机分为3组:A组给予帕瑞昔布,B组给予塞来昔布,C组给予0.9%氯化钠注射液。所有患者术前1 h、术后12、24 h给药,观察术后1、6、12、24 h的视觉模拟疼痛评分(visual analog score,VAS)、吗啡消耗量及不良反应的发生情况。结果 A组吗啡用量在6、12、24h低于B组和C组,差异有统计学意义(P<0.05),B组低于C组,差异有统计学意义(P<0.05)(A组平均为8.1mg、11.0mg、13.73 mg;B组平均为11.4 mg、18.2 mg,25.28 mg;C组平均为16.3 mg、25.4 mg、37.5 mg)。A组VAS评分在1、6、12 h低于B组和C组,差异有统计学意义,B组在6 h低于C组,差异有统计学意义(P<0.05)(A组平均为5.4,4.3,3.5;B组平均为7.1,5.2、4.4;C组平均为7.3,6.2,4.7)。3组在镇静状态方面差异有统计学意义(P<0.05),其他不良反应之间差异无统计学意义。结论术前给予帕瑞昔布比塞来昔布能够更有效地减少术后吗啡用量和降低VAS评分。

Objective To compare analgesic effects of parecoxib sodiuml and celecoxib after lumbar fusion surgery. Methods One hundred and twenty patients after lumbar fusion surgery were randomly divided into parecoxib sodiuml treatment group（group A）, celecoxib treatment group（group B） and control group（group C）, 40 in each group. All patients were given drugs lh before operation and 12 and 24 h after operation. Their visual analog score（VAS）, morphine consumption and incidence of adverse effects were observed at 1, 6, 12 and 24 h after operation. Results The morphine consumption was less in group A than in groups B and C at 6, 12 and 24 h after operation（8.1 mg, 11.0 mg, 13.73 mg vs 11.4 mg, 18.2 mg, 25.28 mg vs 16.3 mg, 25.4 mg, 37.5 mg, P 〈 0.05）. The VAS score was lower in group A than in groups B and C at 1, 6 and 12 h after operation（5.4, 4.3, 3.5 vs 7.1, 5.2, 4.4 vs 7.3, 6.2, 4.7, P 〈 0.05）. The analgesic effects of parecoxib sodiuml and celecoxib were significantly different（P 〈 0.05） while no significant difference was found in adverse effects among the 3 groups. Conclusion Parecoxib sodiuml given before operation is more effective to reduce postoperative morphine consumption and VAS score than celecoxib.