帕瑞昔布钠超前镇痛对妇科腹腔镜术后疼痛的影响

Effect of preemptive analgesia with parecoxib sodium on pain after laparoscope in gynecology department

目的：观察帕瑞昔布钠超前镇痛方案对妇科腹腔镜手术患者疼痛及术后并发症的影响。方法：选取2013年1月～2014年2月行妇科腹腔镜手术的患者共100例，ASAI～Ⅱ级，随机分为观察组与对照组，观察组患者于术前30rain给予帕瑞昔布钠40rag静脉注射，手术结束前30min给予1．0μg／kg枸椽酸芬太尼注射液静脉注射；对照组于手术结束前30min时给予40mg帕瑞昔布钠和1．0μg／kg枸椽酸芬太尼注射液静脉注射，观察两组患者术后4，8，12h镇痛、镇静效果，并记录术后追加芬太尼总量及不良反应发生情况。结果：观察组患者术后各时间点VAS镇痛评分及芬太尼总用量均显著低于对照组（P〈0．05）；两组术后Ramsay镇静评分及不良反应发生率比较差异无统计学意义（P〉O．05）。结论：帕瑞昔布钠超前镇痛可减少患者术后镇痛药物用量，镇痛效果确切，可在临床推广应用。

Objective： To observe the effect of preemptive analgesia with parecoxib sodium on pain after laparoscope in gynecology department. Methods： A total of 100 cases with surgery under laparoscope, at stage ASA Ⅰ-Ⅱ , admitted from Janu ary 2013 to February 2014 were selected. They were randomly divided into observation group and control group. Patients in observation group were treated with intravenous injection of parecoxib sodium 40 mg 30 min before surgery, and with intrave- nous injection of fentanyl citrate 1.0μg/kg 30 min before the end of surgery. Patients in control group were treated with intra- venous injection of pareeoxib sodium 40 mg and fentanyl citrate 1.0 μg/kg 30 min before the end of surgery. The analgesia and sedative effect at 4, 8, 12 h after surgery were observed. The additional dosage of fentanyl and the incidence of side effect were also observed. Results= Analgesia score VAS at every time point and total dosage of fentanyl were significantly lower in obser- vation group （P〈0.05）. There was no significant difference in Ramsay sedative score and incidence of side effect between two groups（P〉0.05）. Conclusions： Preemptive analgesia with parecoxib sodium can reduce the dosage, and is of exact analgesia effect. It is worthy clinical application. KEYWORDS Preemptive analgesia; Laparoscope Parecoxib sodium; Fentanyl