帕瑞昔布钠、曲马多和芬太尼用于多模式镇痛的效果比较

Efficacy Comparison in the Application of Parecoxib Sodium,Tramadol and Fentanyl for Multimodal Analgesia

目的比较帕瑞昔布钠、曲马多和芬太尼在多模式镇痛中的应用效果。方法选取医院胸外科开胸手术患者90例,随机分为A,B,C 3组。在手术缝合皮肤时分别静脉给予患者自控镇痛负荷剂量,A组给予曲马多1 mg/kg,B组给予芬太尼1μg/kg,C组给予帕瑞昔布钠40 mg,启动镇痛泵。评估给药后1,2,3,4,5,6 h时患者疼痛状况,疼痛评估采用视觉模拟评分(VAS);记录患者全身麻醉苏醒期发生不良反应的例数,统计其发生率。结果C组明显比A组和B组的镇痛时间长,镇痛效果好,B组略优于A组(P<0.05);不良反应发生率C组明显比A组和B组低,拔管平稳。结论帕瑞昔布钠可作为术后患者自控镇痛负荷剂量的理想用药。

Objective To compare the effects of parecoxib sodium, tramadol and fentanyl in muhimodal analgesia. Methods Ninety adult patients suffering from open thoracotomy were randomized into three groups referred as A, B and C. They received intravenously tramadol 1 mg/kg （group A）,fentanyl μg/kg （group B）,and parecoxib sodium 40 mg（group C）,according to patient controlled analgesia loading dose when skin was sutured with PCIA stared. The analgesic effect was observed by VAS at 1,2,3,4,5,6 h after injection. Record the side effect rate during waking up period after general anesthesia. Results Analgestic effect in group C was obviously better than that in the other two groups; side effect rate in group C was significantly lower than that in group A and group B. Conclusion Parecoxib sodium is suitable for patient controlled analgesia loading dose after operation.