帕瑞昔布钠与曲马多联合对妇科腹腔镜术后镇痛的实效性评价

Effectiveness of Parecoxib sodium combined with Tramadol for postoperative analgesia in gynaecological laparoscopic surgery

目的探讨帕瑞昔布钠(Parecoxib sodium,Par)联合曲马多(Tramadol,TR)在妇科腹腔镜术(laparoscopic surgery,LS)后的镇痛效果。方法选择2014年8月—2016年3月在温州医科大学附属第二医院接受LS手术的患者82例,随机分成观察组41例和对照组41例,对照组手术结束前30 min静注曲马多2 mg/kg,观察组在对照组的基础上术前30 min静注40 mg帕瑞昔布钠。评估2组患者术后0.5、2、4、12和24 h的VAS(visual analogue scale)评分和自主呼吸恢复时间、意识恢复时间、拔管时间及不良反应发生情况。结果观察组术后0.5、2、12和24 h的VAS评分分别为(1.7±0.5)分、(1.9±0.8)分、(1.7±1.0)分和(1.2±0.4)分,对照组为(3.2±0.6)分、(3.4±1.0)分、(3.1±0.8)分和(1.9±0.6)分,观察组术后各时点的VAS评分明显低于对照组(P<0.05);2组自主呼吸恢复时间、意识恢复时间、拔管时间相比,差异均无统计学意义(P>0.05);观察组不良反应率为7.3%(3/41),对照组为9.7%(4/41),2组不良反应率相比,差异不具有统计学意义(P>0.05)。结论 Par联合TR在LS术后早期疼痛的发生具有明显的预防效果,且安全性高,值得在临床上进一步推广。

Objective To explore the preventive effect of Parecoxib sodium （Par） combined with Tramadol （TR） for postoperative analgesia in Gynaecological Laparoscopic surgery（LS）. Methods Total 82 cases undergoing surgical treat- ment in our hospital from August,2014 to March ,2016 were selected, and randomly divided into the observation group and the control group with 41 cases in each group. The control group was intravenous injected 2 mg/kg Tramadol at 30 rain be- fore the end of surgery ,while the observation group was treated with 40 mg Par 30 min before surgery on the basis of con- trol group. The visual analog scale（VAS） at 0.5 h ,4 h, 12 h and 24 h postoperative, spontaneous breathing recovery time, consciousness recovery time, time to extubation, and incidence of adverse reactions of two groups were recorded and com- pared. Results VAS score at 0.5 h,4 h, 12 h and 24 h after surgery in observation group were （ 1.7 ± 0.5 ） points, （ 1.9 ± 0. 8 ） points, （ 1.7 ± 1. 0） points and （ 1.2 ± 0.4 ） points, respectively, while in the control group were （ 3.2 ± 0.6） points, （3.4 ± 1.0） points, （3.1 ± 0.8） points and （ 1.9 ± 0.6） points, respectively, VAS scores of each check- point in the observation group were significantly lower than the control group （ P 〈 0.05 ） ; there was no significant differ- ence in the recovery time of spontaneous breathing, consciousness recovery time and time to extubation between the two groups （P 〉 0.05 ） ;the incidence of adverse reaction was 7.3 % （3/41 ） in the observation group, while was 9.7 % （4/41 ） in the control group, the difference between the two groups was not statistically significant （ P 〉 0.05 ）. Conclusion Par combine with TR in LS has a significant preventive effect for early postoperative pain, and with high safety, worthy of further promotion in clinical practice.