帕瑞昔布钠预防腹腔镜阑尾切除患者全麻苏醒期躁动和疼痛的临床观察

Clinical observation of Parecoxib in Drenvention of a^itation and ~ain durin~ recovery period of general anesthesia in patients with laparoscopic appendectomy

目的观察帕瑞昔布钠对腹腔镜阑尾切除患者全麻苏醒期躁动和疼痛的影响。方法全身麻醉下行择期腹腔镜阑尾切除术患者50例，年龄20—50岁，体质量45—70kg，ASAI一Ⅱ级。随机均分为两组，双盲对照观察。术毕前20min静脉用帕瑞昔布钠40mg为P组、术毕前20min静脉用生理盐水2ml为c组。观察患者睁眼时间、拔管时间；拔管后1h（T1）、术后4h（T2）、术后12h（T3）、术后24h（T4）VAS评分、苏醒期躁动评分（RS）、Ramsay镇静评分（RSS）以及术后不良反应的发生。结果P组和c组睁眼、拔管时间比较差异无统计学意义（P〉0．05）；P组T1、T2、L3、T4时段VAS评分明显低于C组（P〈0．05）；P组的苏醒期躁动评分（RS）明显低于C组（P〈0．05）、P组的镇静评分（RSS）明显高于C组（P〈0．05）；各组术后不良反应的发生率比较差异无统计学意义（P〉0．05）。结论腹腔镜阑尾切除术中使用帕瑞昔布钠具有良好的镇痛以及减少患者苏醒时躁动的作用，同时并不增加苏醒时间和术后的不良反应发生率。

Objective To observe the effect of parecoxib on the prevention of agitation and pain during recovery period of general anesthesia after laparoscopic appendectomy. Methods Fifty laparo- scopic appendectomy patients with ASA I - II , age from 20-50 years old, weight 45 - 70 kg were select- ed under general anesthesia. They were divided into two groups randomly and were observed by double blind contrast test. The patients in group P were intravenously injected with parecoxib 40 mg at 20 mi- nutes before the end of operation, and the patients in group C were intravenously injected with physiologi- cal saline 2 ml. The time of opening eyes, and the time of extubation. VAS about 1 hour after extubation （T1 ） , 4 hours after operation（ T2 ）, 12 hours after operation（ T3 ） , 24 hours after operation（ T4 ） ; RS and RSS during general anesthesia revival period and adverse reactions after operation were observed. Results There was no obvious difference in the time of awakening and the time of extubation in group P and group C. VAS Scores about T1 ,T2,T3 ,T4 in group P were significantly lower than those in group C （ P 〈 0. 05 ）. RS in group P was obviously lower than that in group C （ P 〈 0. 05 ） ; RSS in group P was distinctly higher than that in group C （P 〈 0.05 ）. There was no obvious difference on adverse reactions after operations in each group. Conclusions Parecoxib has good effect on pain-relieving and reducing patients＇agitation during general anesthesia revival period in laparoscopic appendectomy operation, and at the same time dose not increase the incidence of adverse reactions after operations.