帕瑞昔布钠用于腹腔镜异位妊娠手术的临床观察

Clinical observation of parecoxib sodium in laparoscopic surgery for ectopic pregnancy

目的探讨帕瑞昔布钠对腹腔镜异位妊娠手术全麻拔管期血流动力学以及术后疼痛的影响。方法选择2015年1月1日～5月31日期间因异位妊娠需行腹腔镜手术治疗的患者80例，年龄20～45岁，ASAⅠ～Ⅱ级。采用随机数字表法将患者随机分为帕瑞昔布钠组（P组）和对照组（C组）。气管插管后手术开始前P组静脉注射帕瑞昔布钠40mg，C组静脉注射等剂量的生理盐水，观察两组用药前、拔管前、拔管时、拔管后5min和拔管后10min的HR、SBP和DBP，观察并记录患者术后30min、1h、2h．4h,6h和12h的VAS评分。结果与C组比较，P组患者的SBP和DBP在拔管前、拔管时、拔管后5min和拔管后10min均明显降低（P〈0．05），HR在拔管前、拔管时、拔管后5min和拔管后10min均明显减慢（P〈0．05）。P组术后30min、1h,2h、4h和6h的VAS评分明显低于C组（P〈0．05），两组术后12h的VAS评分无显著性差异（P〉0．05）。结论手术开始前静脉注射帕瑞昔布钠40mg，能有效维持腹腔镜异位妊娠手术全麻拔管期间的血流动力学平稳，并能有效缓解患者的术后疼痛，提高患者的舒适度。

Objective To investigate the effects of parecoxib sodium in hemodynamics during extubation of general anesthesia period and postoperative pain of laparoscopic surgery for ectopic pregnancy. Methods A total of 80 cases of patients who demanded for ectopic pregnancy laparoscopic surgery from January 1st to May 31st in 2015 were chosen, aging from 20 to 45 years old, with ASA ranging from Ⅰ to Ⅱ level. Random number table was used to divide the patients into the parecoxib sodium group （group P） and the control group（group C）. After tracheal intubation and before the start of the surgery, group P received intravenous injection of 40 mg parecoxib sodium, and group C received intra- venous injection of the same dose of saline. SBP and DBP of the two groups before intravenous injection, before extn- bation, on extubation, 5 min and 10 min after extubation were observed, and VAS scores of patients 30 min, 1 h, 2 h, 4 h, 6 h and 12 h after surgery were observed and recorded. Results Compared with those in group C, SBP and DBP of patients in group P, before extubation, on extubation, 5 min and 10 min after extubation significantly reduced （P〈 0.05）, and HR of patients in group P before extubation, on extubation, 5 min and 10 min after extubation significantly slowed （P〈0.05）. VAS scores of group P 30 min, 1 h, 2 h, 4 h and 6 h after surgery were significantly lower than those in group C （P〈0.05）, but the difference of postoperative 12 h VAS score was not significant （P〉0.05）. Conclusion Intravenous injection of 40 mg parecoxib sodium before surgery can effectively maintain stable hemodynamics during extubation period of general anesthesia in laparoscopic surgery for ectopic pregnancy, can effectively relieve patients＂ postoperative pain, and improve patients＂ comfort degree.