塞来昔布超前镇痛在腹腔镜术后镇痛的效果

Outcomes of preemptive analgesia with celecoxib in patients undergoing laparoscopic operations

目的探讨塞来昔布超前镇痛在腹腔镜术后镇痛的效果。方法腹腔镜手术患者采用两种镇痛方案:B组30例,术后6h开始每12小时口服塞来昔布200mg,直至48h。A组31例,术前2h加用塞来昔布400mg口服。术后VAS疼痛评分>3分时,静脉给予地佐辛0.1-0.2mg/kg。记录术后2、4、6、8、12、24h和48h的VAS疼痛评分、追加地佐辛镇痛的用量和不良反应发生情况。结果 A组术后2、4h和6h的VAS疼痛评分均优于B组[(1.5±0.4)分vs.(3.7±0.6)分、(1.7±0.5)分vs.(4.7±0.1)分和(1.9±0.4)分vs.(5.3±0.2)分](P<0.05)。A组术后追加地佐辛的用量少于B组[(0.57±0.21)mg vs.(2.75±0.87)mg](P<0.05)。两组术后恶心、呕吐、头痛等不良反应发生率和切口渗血量差异均无统计学意义(P>0.05)。结论塞来昔布超前镇痛可以有效控制腹腔镜术后疼痛,并可以显著减少追加镇痛药物的需求。

Objective To investigate the efficacy of preemptive analgesia with celecoxib in the patients undergoing laparoscopic operations.Methods Preemptive analgesia with oral celecoxib400 mg at 2hours before operation was performed in 31 cases undergoing laparoscopic operations（group A）,which was followed by oral celecoxib 200 mg every 12 hours started at 6hours after operation until 48 hours.Postoperative analgesia with oral celecoxib 200 mg every 12 hours as in group A was performed in 30cases（group B）.Dezocine 0.1-0.2mg/kg was used intravenously when VAS pain score〉3points after surgery.VAS pain scores were evaluated at 2,4,6,8,12,24 and 48hours after operation.The amount of dezocine as a postoperative additional analgesics and adverse effects were recorded.Results VAS scores at 2,4and 6hours after operation were lower in group A than those in group B[（1.5±0.4）points vs.（3.7±0.6）points,（1.7±0.5）points vs.（4.7±0.1）points and（1.9 ± 0.4）points vs.（5.3 ± 0.2）points]（P〈0.05）.The amount of dezocine used postoperatively was more in group A than that in group B[（0.57±0.21）mg vs.（2.75±0.87）mg]（P〈0.05）.The incidences of adverse effects of two groups during analgesia were similar（P〈0.05）.Conclusion Preemptive analgesia with celecoxib can effectively improve postoperative analgesia and reduce the need for additional analgesics in the patients undergoing laparoscopic operations.