帕瑞昔布钠用于全麻下鼻内镜手术超前镇痛效果的观察

Clinical efficacy of parecoxib sodium on preemptive analgesia in patients undergoing endoscopic sinus surgery

目的探讨帕瑞昔布钠的超前镇痛效果。方法 56例全麻下行鼻内镜手术患者,随机分为对照组和实验组各28例。比较各组麻醉药用量,测术后24 h内VAS和BCS,观察拔管前10 min(T1)、拔管时(T2)、拔管后10min(T3)3个时点的RS和RSS评分,观察阿片类药物使用后患者不良反应。结果术前使用帕瑞昔布钠并未减少术中麻醉药用量;实验组术后2 h、6 h、12 h的VAS评分显著低于对照组(P<0.05),同时术后2 h、6 h、12h的BCS评分显著高于对照组(P<0.05);实验组苏醒期T1、T2、T3三个时点的RS低于对照组(P<0.05),且T2、T3两个时点的RSS高于对照组(P<0.05);帕瑞昔布钠能有效降低术后患者早期发热。结论帕瑞昔布钠作为超前镇痛用于全麻下鼻内镜手术,可有效减轻术后疼痛,减少全麻苏醒期躁动,效果确切。

Objective To observe the preemptive analgesia of parecoxib sodium on endoscopic sinus surgery. Methods Fifty-six cases were divided into control group and experiment group randomly （n=28 in each group）. The amount of anesthetic use was recorded. The pain score was evaluated with VAS and BCS after the operation 24 h. The RS and RSS were measured 10 min before tracheal extubation（T1） ,tracheal extubation （T2）, and 10min after tracheal extubation （T3）. The incidence of adverse events was recorded after the operation. Results Compared with control group,the amount of anesthetic use wasn＇ t reduced in parecoxib sodium group. The VAS scores of parecoxib sodium group lower than control group at 2 h, 6 h, 12 h after surgery（P 〈 0.05）. The BCS scores of parecoxib sodium group higher than control group at 2 h, 6 h, 12 h after surgery（P 〈 0.05）. The RS scores of parecoxib sodium group lower than control group at T1, T2, T3 in resuscitation after general anesthesia（P 〈 0.05 ）. Furthermore, the RSS scores of parecoxib sodium group higher than control group at T2, T3 in resuscitation after general anesthesia（P 〈 0.05 ）. Parecoxib sodium can effectively reduce the fever of postoperative patient. Conclusion The preincisional administration of parecoxib sodium after endoscopic sinus surgery result significant preemptive analgesic effect,reduce postoperative pain and emergence agitation.