塞来昔布联合普瑞巴林预先给药对老年骨科患者术后疼痛的影响

Effects of premedication with celecoxib and pregabalin on postoperative pain in the elderly orthopedic patients

目的：观察塞来昔布联合普瑞巴林预先给药用于老年骨科患者的安全性，及对术后疼痛的影响。方法：择期行股骨头或全髋关节置换术的老年病人100例，ASAⅠ～Ⅱ级，随机分为4组（n一25）：安慰剂对照组（C组）、塞来昔布组（S组，200mg）、普瑞巴林组（P组，300mg）、塞来昔布和普瑞巴林联合用药组（L组，塞来昔布200mg和普瑞巴林150mg）。记录术毕苏醒时间、术后2、4、6、8、12、24h的体动视觉模拟疼痛评分（VAS）和Ramsay镇静评分，以及术后72h内芬太尼和曲马多的总用量，以及头晕、嗜睡、恶心呕吐等不良反应的发生率。结果：体动VAS评分：术后2、4、6、8hC组高于同时间点其他组，术后8、12hL组低于同时间点其他组（P〈0．05）。Ramsay评分：术后2、4、6hP组高于同时间点其他组，术后2、4hL组高于同时间点C组和S组（P〈0．05）。与P组比较，C组、S组和L组苏醒时间更短（P〈0．05）；与C组比较，术后72h内S组、P组和I。组的芬太尼和曲马多用量减少（P〈0．05）；与L组比较，S组和P组芬太尼和曲马多用量增加（P〈0．05）；与P组比较，C组、S组和L组术后不良反应发生率明显降低，差异有统计学意义（P〈0．05）。结论：塞来昔布联合普瑞巴林预先给药可安全用于老年骨科患者，且能明显减轻术后疼痛。

AIM To effect on postoperative observe the safety and pain of premedication with celecoxib and pregabalin in the elderly orthopedic patients. METHODS. One hundred ASA I or II elderly patients aged 68 -- 84 year and weighing 52--64 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 4 groups （n = 30 each）： control group（group C）, celecoxib group（group S）, pregabalin group（group P） and combination group（group L）. Celecoxib 200 mg was taken in group S, pregabalin 300 mg was taken in group P, celecoxib 200 mg and pregabalin 150 mg were taken in group L before operation 1 h, while in group C placebo was taken. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients in 72 h after operation. If VAS score was more than 3, a bolus of fenta- nyl 0.2μg/kg was given i.v.. And then the re- covery time, moving VAS score and Ramsay score at 2,4,6,8,12,24 h postoperation, and to- tal amount of fentanyl and tramadol in 72 h post- operation, and the incidence of adverse reaction included dizzy, lethargy, nausea were recorded. RESULTS-Moving and vomiting VAS score in group C at 2,4,6,8 h postoperation was higher than in other groups score in group L at lower. Ramsay score operation was higher the same time, while h postoperation was at the same time, while the 8, 12 h postoperation was in group P at 2,4,6 h post- than that in other groups at the score in group L at 2,4 higher than that in group C and S. Compared with group P, the recovery time was shorter in group C, S and L. Compared with group C, the total amount of fentanyl and tramadol consume smaller in group group L, the total d in 72 h postoperation was S, P and L. Compared with of fentanyl and tram adol consumed was bigger in group Compared with group P, the incidence reaction was lower in group C, S an 0.05）. CONCLUSION. Celecoxib corn S and P. of adverse d L （P〈 bined with pregabalin pretreatment can be used safely elderly orthopedic patients, and can significant reduce postoperative pain.