帕瑞昔布钠复合地佐辛用于改善开胸术患者麻醉恢复期质量的效果观察

Effects of parecoxib sodium combined with dezocine on the anesthesia recovery period after thora-cotomy

目的探讨帕瑞昔布钠复合地佐辛对提高开胸术患者麻醉恢复期质量的效果。方法择期开胸手术患者60例，随机分为三组（n=20）：P组：麻醉前10min静脉注射帕瑞昔布钠40mg（5m1）；D组：术毕前20min静脉注射地佐辛0．2mg／kg；PD组：麻醉前10min静脉注射帕瑞昔布钠40mg（5ml）＋术毕前20min静脉注射地佐辛0．1mg／kg。于麻醉前（T1）、拔管前即刻（T2）、拔管后1min（T3）、拔管后5rain（T4）时记录呼吸（HR）、平均动脉压（MAP），记录苏醒、拔管时间。评估拔管后5min时的躁动（RS）评分、镇静（RSS）评分，和舒适（BCS）评分。结果与PD组相比，P组他、T3时刻HR增快，MAP增高；RS评分增高，与D组、PD相比差异有统计学意义（P〈0．05）；D组苏醒、拔管时间延长，RSS评分增高，与P组、PD相比差异有统计学意义（P〈0．05）；PD组BCS评分增高，与P组、D相比差异有统计学意义（P〈0．05）。结论麻醉前10min帕瑞昔布钠40mg复合术毕前20min0．1mg／kg地佐辛静注用于开胸手术后，患者有满意的麻醉恢复期循环变化，且不影响患者的苏醒、拔管时间，苏醒质量高，具有一定的临床应用价值。

Objective To investigate the effectivness of parecoxib sodium combined with dezo-cine on improvement of the quality in the anesthesia recovery period after thoracotomy. Methods Sixty patients received thoracotomy under elective general anesthesia were randomly divided into three groups： group P（n =20） ：parecoxib sodium 40 mg intravenously 10 min before anesthesia, group D（n = 20） ： dezocine 0.2 mg/kg intravenously 20 rain before the end of surgery, group PD （ n = 20） ： parecoxib sodi-um 40 mg intravenously 10 min before anesthesia combined with dezocine 0.1 mg/kg intravenously 20 min before the end of surgery. The HR and MAP were recorded before anesthesia（T1 ） , before extubation （T2） , after extubation 1 min （ T3 ）, 5 min （T4）. The time of analepsia and extubation were recorded. The RS, RSS and BCS scores were also recorded. Results The group P were higher than group D and group PD in the changes of HR, MAP and the RS score, the difference was statistically significant（P 〈 0.05 ）. The group D were higher than group P and group PD in the length time of analepsia, extubation and the RSS score, the difference was statistically significant （ P 〈 0.05 ）. The group PD were higher than group D and group P in the BCS score, the difference was statistically significant （ P 〈 0.05 ）. Conclu-sions Parecoxib sodium 40 mg intravenously 10 min before sugery combined with dezocine 0.1 mg/kg intravenously 20 min before the end of surgery was a good choice in the anesthesia recovery period after thoracotomy, without affecting the time of analepsia and extubation, with satisfactory circulation changes and high quality of analepsia.