舒芬太尼经鼻给药复合帕瑞昔布钠用于鼻内窥镜术后镇痛

Efficiency and safety of multimodal analgesia use in nasal endoscope operation with the compound of sufentanil with parecoxib sodium through nose

目的观察舒芬太尼经鼻给药复合帕瑞昔布钠多模式镇痛在鼻内窥镜手术后的镇痛效果及安全性。方法选择择期行鼻内窥镜手术的患者60例,随机分成3组,S1组,术毕经鼻腔给予舒芬太尼25μg,并静注帕瑞昔布钠40 mg;S2组,术毕经鼻腔给予舒芬太尼15μg,并静注帕瑞昔布钠40 mg;C组,术毕经鼻腔给予生理盐水,并静注帕瑞昔布钠40 mg。分别于术毕即刻(T0)、拔管前10 min(T1)、拔管即刻(T2)、拔管后10 min(T3),记录收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、心率(HR),并于麻醉清醒拔管后10 min,术后4、12、24 h记录视觉疼痛模拟评分(VAS评分),同时记录患者在术后24h内的不良反应。结果 S1、S2组在T2、T3时点的SBP、DBP、MAP、HR与C组相比明显降低(P<0.05);S1组各时点VAS评分明显优于S2和C组(P<0.05),S2组各时间点VAS评分明显优于C组(P<0.05)。结论鼻内窥镜手术后经鼻腔给予25μg舒芬太尼,并复合帕瑞昔布钠40 mg静注对术后疼痛有明显的减轻作用,且安全性较高。

Objective To observe the efficiency and safety of multimodal analgesia use in nasal endoscope operation with the compound of sufentanil with parecoxib sodium through nose. Meathods Sixty nasal endoscope operation patients were divided into three groups randomly. Group A was S1 group, 2μg sufentanil was administered through nose after operation, and 40 mg parecoxib sodium was injected. Group B was S2 group, 15μg sufentanil was administered through nose after operation, and 40 mg parecoxib sodium was injected. Group C was administered physiological saline through nose after operation, and was injected with 40 nag parecoxib sodium. Systolic pressure（SBP）, diastolic pressure（DBP）, mean arterial pressure（MAP） and heart rate （HR） were recorded respectively immediately at operation （T0）, 10 minutes before extubation（T1 ）, extubation （T2） and 10 minutes after extubation（Ts）. And visual pain analog scale （VAS） was recorded respectively 10 minutes after anesthesia for awake after extubation, 4 hours after operation, 12 hours after operation and 24 hours after operation. Adverse reaction 24 hours after operation was recorded as well. Results SBP, DBP, MAP and HR of group S1 and group $2 at the moment of T2 and T3 were obviously lower than group C （ P 〈 0.05）. Visual pain analog scale of group S1 at each moment was obviously better than group C （P 〈 0.05）. Conclusion Twenty - fiveμg sufentanil through nose after operation combined with iniection of 40 mg parecoxih sodium can relieve pain after operation noticeably and safely.