帕瑞昔布钠与地佐辛对腰椎手术患者全麻苏醒期的影响

The effect of parecoxib sodium and dezocine during general anesthetic recovery after orthopaedic lumbar spine surgery

目的：比较帕瑞昔布钠与地佐辛对腰椎内固定手术患者全麻苏醒期的影响。方法根据美国麻醉医师协会（ASA）分级，选择60例Ⅰ～Ⅱ级择期行腰椎内固定手术患者，随机分为帕瑞昔布钠组（P组）、地佐辛组（D组）和对照组（C组），每组20例。术毕前30min P组静脉注射帕瑞昔布钠40mg，D组静脉注射地佐辛5mg，C组输注生理盐水5ml。观察3组患者苏醒期的循环情况，拔管后疼痛评分、舒适度评分及躁动评分，同时观察苏醒时间及拔管时间。结果 P组和D组围拔管期各时点的血压、心率及术后疼痛评分，躁动评分均显著低于C组，舒适度评分显著高于C组（P〈0.05）。 D组苏醒时间、拔管时间均显著长于P组和C组（P〈0.05），而P组与C组比较差异无统计学意义（P〉0.05）。结论术毕前30min静脉注射帕瑞昔布钠40mg或地佐辛5mg均可维持腰椎内固定手术患者全麻苏醒期的循环稳定，减轻术后疼痛，减少术后躁动，但帕瑞昔布钠不影响麻醉的苏醒时间，效果更佳。

Objective To compare the effect of parecoxib sodium and dezocine during general anesthetic recovery after orthopaedic lumbar spine surgery. Methods Sixty ASAⅠ~Ⅱpatients who were scheduled for orthopaedic lumbar spine surgery were randomly divided into three groups （group P, group D and group C）. Group P and group D respectively received intravenous injection of parecoxib sodium 40mg and dezocine 5mg at 30min before the end of operation , while group C received intravenous injection of normal saline instead. Recorded the SBP,DBP,HR,VAS score,BCS score and agitation scale,awakening time and extubation time. Results The blood presure,heart rate during extubation period, VAS score, agitation scale of group P and group D were significantly lower, and BCS score was significantly higher than those in group C （P〈0.05）. The awakening time, extubation time of group D were significantly higher than group P and group C （P〈0.05）, while there was no difference between group P and group C （P〉0.05）. Conclusion Using 40mg parecoxib sodium or 5mg dezocine at 30min before the end of operation all has a stabilizing effect on the hemodynamics,can effectively relieve postoperative pain, prevent the agitation during the recovery period of general anesthesia, but parecoxib sodium does not affect the awakening time on the patients with orthopaedic lumbar spine surgery.