帕瑞昔布钠联合地佐辛预防开胸手术患者全麻苏醒期躁动的临床研究

Clinical study of parecoxib sodium combined with dezocine on prevention of agitation in patients with thoracic surgery

目的探讨帕瑞昔布钠(parecoxib sodium,PS)、地佐辛(dezocine,Dez)以及两药联合预防开胸手术患者全麻后苏醒期躁动的临床疗效及安全性。方法 107例全麻开胸手术患者用随机数字表随机分为PS组(n=36)、Dez组(n=34)和两药联合组(n=37)。每组患者分别于手术结束前半小时静脉注射相应药物。PS组静脉注射PS 40 mg;Dez组静脉注射Dez 10 mg;联合用药组静脉注射PS 40 mg+Dez 10 mg,观察3组患者苏醒期Ramsay镇静评分、RASS躁动分级及发生率和相关毒副反应。结果联合用药组Ramsay镇静评分显著高PS组和Dez组(P<0.05);联合用药组躁动发生率显著低于PS组和Dez组(P<0.05);PS组与Dez组间比较Ramsay镇静评分和躁动发生率无明显差别(P>0.05)。3组患者不良反应发生率差别无统计学意义(P>0.05)。结论 PS联合Dez可有效预防全麻开胸术后苏醒期患者躁动的发生率。

Objective To evaluate the clinical efficacy and safety of parecoxib sodium combined with dezocine on prevention of agitation in patients with thoracic surgery. Methods One hundred and seven patients with thoracotomy were divided into parecoxib sodium group（ n = 36）,dezocine group（ n = 34） and combined group（ n = 37）. The patients in each group were given the parecoxib sodium 40 mg iv,dezocine 10 mg iv and sodium 40 mg ＋ dezocine 10 mg 30 minutes prior the end of the operation in PS group,Dez group and combined group,respectively. The Ramsay sedation score,Rass agitation grading and side effects were evaluated in each of the three groups. Results The Ramsay sedation score in combined group was much higher than that in PS and Dez group（ P 0. 05）. The incidence rate of Rass agitation in combined group was much lower than that in PS and Dez group（ P 0. 05）; but the Ramsay sedation score and incidence rate of Rass agitation were not significant different between the PS and Dez group（ P 0. 05）. And no difference of side effects was observed among the three groups（ P 0. 05）. Conclusion Parecoxib sodium combined with dezocine can significant reduce the risk of developing agitation in patients received thoracotomy.