地佐辛联合帕瑞昔布钠在混合痔患者术后镇痛中的应用

Application of Dezocine plus Parecoxib Sodium to Postoperative Analgesia of Mixed Hemorrhoids Patients

为探讨地佐辛联合帕瑞昔布钠在混合痔患者术后镇痛中的应用效果，选择择期行混合痔切除术者80例进行研究，患者ASA分级Ⅰ～Ⅱ级，均采用腰硬联合阻滞麻醉，腰麻药物为0．5％罗哌卡因1．5ml。将80例患者随机分为四组，即生理盐水组（NS组）、地佐辛组（D组）、帕瑞昔布钠组（P组）、地佐辛联合帕瑞昔布钠组（DP组），各20例，于手术结束前10min经静脉滴注相应药物。对比各组患者术后4h（T4）、8h（T8）、12h（T12）、24h（T24）时的疼痛情况（VAS评分）、术后补给镇痛药（双氯芬酸钠缓释片）量和不良反应。结果显示，T。时点各组间VAs评分比较差异无统计学意义，P〉0．05。T8和T12时点，P组、NS组、D组VAS评分均高于DP组，差异均有统计学意义，P〈0.05；D组与P组比较差异无统计学意义，P〉0.05。T24时点，DP组VAS评分与P组和D组比较差异无统计学意义，P〉0．05；与NS组VAS评分比较差异有统计学意义，P〈0.05。DP组术后补给镇痛药量略少于D组和P组，明显少于NS组，P〈0．05。D组不良反应发生率明显高于其他三组，P〈0．05；DP组和P组比较差异无统计学意义，P〉0.05。结果表明，地佐辛和帕瑞昔布钠联合对混合痔患者进行术后镇痛效果优于两药单独应用，且可以减少其他镇痛药用量，不良反应较少，是一种理想的镇痛方法，值得临床推广应用。

This study was to investigate the application efficacy of Dezocine combined Parecoxib sodium to postoperative analgeisa of mixed hemorrhoids patients.The 80 patients to be schedulely subjected to the resection for mixed hemorrhoids were enrolled in this study and randomly divided into four groups.group NS （normal saline）,group D（Dezocine）, group P（Parecoxib sodium）,and group DP（combination of Dezocine and Parecoxib sodium） visual analogue scale;they being ASA Ⅰ to Ⅱ grade all received associated spinal and epidural block anesthesia （drugs as 1.Sml of 0.5% Ropivacaine） ,20 cases per group,were intravenously injected with above drugs （NS, D, P and D＋ P） when 10min before operation ended, respectively; then, the score on pain at 4h（T4 ）,8h（T8）,12h（T12） and 24h（T24 ） after operation,the dosage of postoperatively added analgesia drugs （Diclofenac sodium sustained-release tablet）,and adverse reaction were compared among above four groups.As results,at T4 there was no statistical difference in VAS score among all groups （ P 〈0.05） ;at T8 and T12 group P,NS and D were all higher than DP（ P〈0.05）,while there was no statistical difference between group D and P （ P 〈0.05） ; at T24 there was no statistical difference between group DP and group P,D（ P 〈0.05）,but compared with NS group DP had significant difference（ P 〈0.05） ;in the dosage of postoperatively added analgesia drugs group DP was slightly less than group D,P, and significantly less than group NS（ P 〈0.05） ;in the adverse reaction incidence group D was significantly higher than other 3 group（ P 〈0.05） ,but there was no statistical difference between group DP and group P（ P 〈0.05）.Results show that the postoperative analgesia of Dezocine combined with Parecoxib sodium is superior to that of each alone,and can reduce other drug dosage,and has less adverse reaction,thus it is an ideal analgesia method, worthy to be popularized to use clinically.