帕瑞昔布在全麻膝关节镜检患者的术后镇痛效果及其对炎症反应的影响

Postoperative analgesia of parecoxib and its effect on inflammatory reaction in patients underwent arthroscopy of the knee joint under general anesthesia

目的观察帕瑞昔布在膝关节镜检患者术后镇痛效果及其对炎症反应的影响。方法全麻下行膝关节镜检查手术患者60例随机均分为两组:A组麻醉前和术后12h静脉注射帕瑞昔布钠40mg;B组给予生理盐水作为对照。于苏醒后即刻(T1)、术后4h(T2)、12h(T3)和24h(T4)评定VAS疼痛评分,检测血清肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)表达,并记录术后不良反应。结果 A组T1-T3时的VAS疼痛评分均明显低于B组(P<0.05或P<0.01);A组术后恶心呕吐发生率也显著低于B组(P<0.05)。A组T1-T4时的TNF-α和IL-6水平均低于B组(P<0.05)。结论全麻前后应用帕瑞昔布具有良好的术后镇痛作用,并能有效减少炎性因子的释放,降低术后各种麻醉不良反应的发生率。

Objective To observe the postoperative analgesia of parecoxib and its effect on inflammatory reaction in patients underwent arthroscopy of the knee joint.Methods Sixty patients undergoing knee arthroscopy under general anesthesia were randomly assigned into two groups.The patients in group A were given parecoxib 40 mg intravenously before anesthesia induction and at 12 hours after operation.Normal saline instead of parecoxib was injected in group B as the control.VAS pain score was evaluated soon after recovery（T1）,at 4（T2）,12（T3） and 24 hours（T4） after surgery.serum tumor necrosis factor-α（TNF-α） and interleukin-6（IL-6） were detected and adverse reactions were recorded as well.Results VAS scores at T1 to T3 were lower in group A than those in group B（P0.05 or P0.01）.Serum TNF-α and IL-6 at T1 to T4 were lower in group A than those in group B（P0.05）.The incidence of nausea and vomiting was lower in group A than that in group B（P0.05）.Conclusion Using parecoxib before and after anaesthesia can provide an effective postoperative analgesia,attenuate release of inflammatory factors and reduce adverse reactions.