帕瑞昔布钠超前镇痛对老年腹部手术患者术后应激和炎性反应的影响

Influence of preemptive analgesia with parecoxib sodium on stress reaction and inflammation reaction in elderly patients after abdominal operation

目的:探讨帕瑞昔布钠超前镇痛对老年腹部手术患者术后镇痛效果、应激及炎症反应的影响。方法:本组腹部手术患者60例随机分为观察组和对照组,每组30例。麻醉前15min观察组静脉注射帕瑞昔布钠40mg(用生理盐水稀释成4mL),对照组静脉注射生理盐水4mL。观察两组术后1、6、12、24h视觉模拟评分(VAS);并于麻醉前5min(T0)、术后1h(T1)、术后6h(T2)、术后12h(T3)、术后24h(T4)取静脉血6mL,测定不同时点皮质醇(Cor)、白介素-6(IL-6)的血浆浓度。结果:观察组患者术后静态和动态不同时点VAS评分均显著低于对照组(P<0.01);T1、T2、T3、T4不同时间点Cor、IL-6血浆浓度均显著低于对照组(P<0.01)。结论:帕瑞昔布钠超前镇痛可有效缓解老年患者腹部手术术后疼痛,减轻应激反应,抑制炎性介质释放。

Objective： ：To investigate the effect of preemptive analgesia with parecoxib sodium on stress reaction and inflammation reaction in elderly patients after abdominal operation. Methods：A total of 60 cases aged 60-75 years old were randomly divided into observation group and control group by half. They, received intravenous injection of parecoxib sodium 40 mg （diluted with saline to 4 mL）15 min before anesthesia in observation group. Patients in control group were injected with saline 4 mL. VAS score was measured 1 h, 6 h, 12 h, 24 h after surgery. 6 mL venous blood was extracted at 5 min before anesthesia （T0）, 1 h after operation （T1）, 6 h after operation （T2）, 12 h after operation （T3）, 24 h after operation （T1） to determine cortisol （Cor） and interleukin-6 （IL-6） concentration. Result. VAS score in observation group at different time points was significantly lower than those of control group （P〈0.01） ; Cor and IL-6 at T1 , T2, T3, T4 were significantly lower than those in the control group （P〈0.01）. Conclusion： preemptive analgesia with parecoxib sodium can effectively relieve postoperative pain in elderly patients with abdominal operation. It can reduce the stress response, and inhibit the release of inflammatory mediators.