帕瑞昔布治疗神经外科患者全麻术后急性疼痛60例

Clinical efficacy of Parecoxib for acute postoperative pain after propofol and remifentanil-induced anesthesia in neurosurgery patients

目的:探讨帕瑞昔布治疗神经外科患者瑞芬太尼和丙泊酚静脉全麻术后急性疼痛的有效性和安全性。方法:将神经外科择期手术患者60例随机分为两组,分别于诱导插管后静脉输注生理盐水5ml(C组)和帕瑞昔布钠40mg(P组)。用视觉模拟评分(VAS)评估患者术后30min、2h、6h、12h、24h的疼痛程度,观察苏醒期躁动、呛咳等不良反应的发生率,并检测患者手术前后肝肾功能指标。结果:术后30min、2h、6hP组VAS评分明显低于C组(P?0.05),术后12、24h两组VAS评分无显著性差异(P>0.05),P组苏醒期躁动、呛咳及术后恶心呕吐的发生率均小于C组(P?0.05),手术前后各项肝肾功能指标均无显著性差异(P>0.05)。结论:帕瑞昔布可减轻神经外科患者瑞芬太尼和丙泊酚静脉全麻术后的早期疼痛和苏醒期躁动、呛咳等不良反应,但对患者肝肾功能无不良影响。

Objective： To observe the effect of parecoxib on acute postoperative pain after propofol and remifentaniMnduced anesthesia in neurosurgery patients. Methods： 60 patients undergoing neurosurgery were ran- domized to two groups. After intubation, 5ml normal saline（group C）and 40mg Parecoxib（group P）were intrave- nously infused, postoperative pain was accessed at 30min, 2h, 6h, 12h, 24h h after surgery by VAS scores. Incidences of the adverse reactions, such as restlessness in stage of analepsia, bucking, were observed. Pre-/post-surgical he- patic and renal functions were tested. Results： 30min,2h,6h after surgery, VAS scores in group P were apparentely lower than those of group C（P 〈0.05）, whereas there was no significant differences between two groups at 12,24h （P 〉0.05）. Pre-/post-surgical hepatic and renal functions showed no significant difference（P 〉0.05）. Conclusion： Parecoxib relieves acute postoperative pain after propofol and remifentanil-induced anesthesia in neurosurgery pa- tients, decreases the incidences of restlessness in stage of analepsia, bucking and has no harmful effects on hepatic and renal functions.