帕瑞昔布预防全麻术后导尿管相关性膀胱刺激征

Evaluation of parecoxib for prevention of catheter-related bladder discomfort after general anesthesia

目的探讨帕瑞昔布40 mg术毕前30 min静脉注射(静注)对全麻术后导尿管相关性膀胱刺激征(CRBD)的影响。方法择期全麻下行胃癌根除术的男性患者40例,随机分为对照组和帕瑞昔布组,每组20例。两组均在气管插管后留置普通导尿管,予丙泊酚、瑞芬太尼、顺阿曲库铵和七氟烷维持麻醉。术毕前30 min,帕瑞昔布组静注帕瑞昔布40 mg(用氯化钠注射液稀释至10 m L),对照组静注同量氯化钠注射液10 m L。观察两组一般情况、镇痛效果、CRBD发生率和严重程度,并记录术后6 h内的不良反应。结果拔管后10 min、30 min、1 h、3 h和6 h时,帕瑞昔布组患者平均动脉压、心率、视觉模拟量表评分、CRBD的发生率和严重程度均低于对照组(P<0.05),两组脉搏血氧饱和度和不良反应发生率比较无显著差异(P>0.05)。结论帕瑞昔布40 mg术毕前30 min静注可降低全麻术后CRBD的发生率和严重程度,维护血流动力学稳定。

AIM To evaluate the effect of parecoxib 40 mg administered iv 30 min before the end of operation for prevention of catheter- related bladder discomfort（ CRBD） after general anesthesia. METHODS Forty male patients scheduled to undergo radical operation for carcinoma of stomach were randomly divided into two groups（ n = 20 each） ： control group（ group C） and parecoxib group（ group P）. In the two groups,urinary catheterization was performed with a 14 Fr Foley＇ s catheter after intubation. Anesthesia was equally maintained with propofol, remifentanil, cisatracurium and sevoflurane in all patients. In the group P, parecoxib40 mg（ diluted with sodium chloride injection into 10 m L） was administered 30 min before the end of operation, while an equal amount of sodium chloride injection in the group C. The general conditions, analgesic effect, and the incidence and severity of CRBD were recorded. And adverse reactions in 6 h after operation were recorded. RESULTS The mean arterial pressure, heart rate, visual analogue scale, and the incidence and severity of CRBD were lower in the group P than those in the group C at 10 min, 30 min, 1 h, 3 h and 6 h after extubation（P〈0.05）. No differences were found in saturation of pulse oximetry and incidence of adverse effects between two groups（P〈0.05）. CONCLUSION Parecoxib 40 mg administered iv 30 min before the end of operation can reduce the incidence and severity of CRBD after general anesthesia and maintain hemodynamic stability.