帕瑞昔布钠对面神经显微血管减压术术后疼痛及躁动的影响

Effect of parecoxib sodium on postoperative pain and restlessness in patients after microvascular decompression

目的观察帕瑞昔布钠对面神经显微血管减压术(MVD)术后疼痛及躁动的影响。方法选择择期行面神经显微血管减压术患者60例,ASAⅠ～Ⅱ级,随机分为帕瑞昔布钠组(P组)和对照组(C组),每组30例。手术结束前30min P组静注帕瑞昔布钠40mg(5ml),C组静注生理盐水5ml,同时两组均静注托烷司琼2mg。观察并记录血流动力学的变化、躁动评分(RS)、镇静评分(SS)、视觉模拟评分(VAS)、麻醉恢复及不良反应发生情况。结果注药前、注药后5min、10min两组患者MAP和HR变化差异无统计学意义;拔管时及拔管后5min、10min P组MAP及HR低于C组(P<0.05)。拔管时及拔管后5min、10min P组RS评分低于C组(P<0.05),SS评分高于C组(P<0.05)。两组患者呼吸恢复时间、睁眼时间、拔管时间、术后恶心、呕吐发生率差异无统计学意义。术后6、12、24h P组VAS、RS评分低于C组(P<0.05),SS评分高于C组(P<0.05)。结论帕瑞昔布钠40mg可安全有效地缓解面神经显微血管减压术术后的疼痛,并可有效预防术后躁动。

Objective To observe the effect of parecoxib sodium on postoperative pain and restlessness in patients after microvascular decompression.Methods Sixty ASA Ⅰor Ⅱ patients undergoing microvascular decompression were randomly divided into two groups with 30 cases each group.Group P received parecoxib 40 mg iv at 30 min before the end of operation.Group C received equal volume of normal saline.All patients also received tropisetron 2 mg at the same time.The hemodynamics,restlessness scores（RS）,sedation scores（SS）,visual analogue scores（VAS）,waking-up and side effects were observed and recorded.Results There was no difference in MAP and HR at 5 min and 10 min after the treatment than before the treatment in two groups.During extubation,at 5 min and 10 min after the extubation,MAP and HR in group P were lower than in group C（P〈0.05）.RS in group P were lower than in group C（P〈0.05）.During extubation,at 5 min and 10 min after the extubation,SS in group P were higher than in group C（P〈0.05）.There were no difference at the time to begin to breathe,the time to open eyes,the time to extubate,and the incidence of postoperative nausea and vomiting.At 6,12,24 h after operation VAS,RS in group P were lower than in group C（P〈0.05）,while SS in group P were higher than in group C（P〈0.05）.Conclusion Parecoxib sodium 40 mg is safe and effect for postoperative analgesia which can effectively prevent the occurrence of restlessnessis after microvascular decompression.