帕瑞昔布钠应用于重症肌无力胸腺切除术后镇痛的效果

Analgesic effect of parecoxib sodium in patients with myasthenia gravis after thymectomy

目的评价帕瑞昔布钠用于重症肌无力患者胸腺切除术后镇痛的效果。方法选择行胸腺切除术的重症肌无力患者157例,分为曲马朵组（51例,术后给予肌肉注射曲马朵1.0~2.0 mg·kg-1）、氟比洛芬酯组（53例,术后予以静脉缓慢滴注0.8~1.0 mg·kg-1氟比洛芬酯）和帕瑞昔布钠组（53例,术后予以静脉缓慢滴注0.6~1.0 mg·kg-1帕瑞昔布钠）,对3组患者术后1、2、6、12、24 h的静息及运动视觉模拟评分（VAS）、平均动脉压（MAP）、心率（HR）、呼吸频率（RR）、血氧饱和度（SpO2）及不良反应发生率进行比较分析。结果氟比洛芬酯组及帕瑞昔布钠组术后1、2、6、12、24 h的静息及运动VAS评分、MAP、HR、RR显著低于曲马朵组,差异有统计学意义（P〈0.05）。帕瑞昔布钠组患者术后1、2、6、12、24 h的静息及运动VAS评分均显著低于氟比洛芬酯组（P〈0.05）。氟比洛芬酯组及帕瑞昔布钠组的不良反应发生率均显著低于曲马朵组（P〈0.05）,且帕瑞昔布钠组的不良反应发生率显著低于氟比洛芬酯组（P〈0.05）。结论重症肌无力患者胸腺切除术后采用帕瑞昔布钠进行镇痛,其镇痛时效显著优于氟比洛芬酯及曲马朵,且镇痛药物剂量小,术后不良反应率低。

Objective To evaluate the analgesic effect of parecoxib sodium in patients with myasthenia gravis after thymectomy. Methods One hundred and fifty-seven patients with myasthenia gravis after thymectomy were divided into tram- adol group（ 51 patients were given intramuscular injection of 1.0 -2.0 mg kg- 1 tramadol） , flurbiprofen axetil group（53 pa- tients were given slow intravenous infusion of 0.8 - 1. 0 mg kg- 1 flurbiprofen axetil） and parecoxib sodium group（ 53 patients were given slow intravenous infusion of 0.6 - 1.0 mg kg - 1 parecoxib sodium）. The resting visual simulation scale （VAS） score, motorial VAS score, mean arterial blood pressure （ MAP）, heart rate （HR） , respiration rate （ RR）, arterial oxygen satura- tion（ SpO2 ） , and adverse reactions of the three groups 1,2,6,12 and 24 h after operation were compared and analyzed in the three groups. Results Resting and motorial VAS scores, MAP, HR and RR of flurbiprofen axetil and parecoxib sodium group were lower than tramadol group 1,2,6,12 and 24 h after operation（ P 〈 0.05 ）. The resting and motorial VAS scores of pare- coxib sodium group were lower than those of flurbiprofen axetil group significantly（ P 〈 0.05 ）. The incidence rates of adverse reactions of flurbiprofen axetil and parecoxib sodium group were lower than tramadol group, while the rate of parecoxib sodium group was lower than flurbiprofen axetil group significantly （ P 〈 0.05 ）. Conclusion The analgesic effect of parecoxib sodium is better than tramadol and flurbiprofen axetil in patients with myasthenia gravis after thymectomy for its small dosage and low adverse reactions.