超前镇痛应用于肺部手术患者对其术后疼痛以及炎性因子的影响探讨

Impact of preemptive analgesia on postoperative pain and inflammatory cytokines of patients with lung surgery

目的 研究探讨超前镇痛应用于肺部手术患者对其术后疼痛以及炎性因子的影响情况。方法选择2013年6月~2015年3月期间在我院接受治疗的肺癌根治术患者64例,随机分成观察组32例和对照组32例。观察组患者于手术麻醉诱导后静注帕瑞昔布钠进行超前镇痛,对照组则相应的静注生理盐水。观察、比较两组患者的术后镇痛效果、不良反应情况、肺功能以及炎性因子IL-8、TNF-α的变化情况等。结果术后6h、12h、18h、24h以及48h,观察组患者的疼痛VAS评分均明显地低于对照组患者（P〈0.05）;两组患者的肺功能指标PA-aO2、RI均较术前显著提高（P〈0.05）,但对照组患者提高的更加明显（P〈0.05）;两组患者的IL-8、TNF-α水平均较术前显著提高（P〈0.05）,但对照组患者提高的更加明显（P〈0.05）;两组患者的不良反应发生情况无明显差异。结论 肺癌手术患者应用帕瑞昔布钠超前镇痛能够有效改善其术后疼痛情况,减轻炎症反应,具有重要的临床意义。

Objective To explore the impact of preemptive analgesia on postoperative pain and inflammatory cytokines of patients with lung surgery. Methods 64 patients with lung surgery were selected from June 2013 to March 2015, and they were divided into the observation group （32 cases） and the control group （32 cases）. The observation group was treated with parecoxib sodium after induction of anesthesia for preemptive analgesia, and the control group was treated with normal saline. The postoperative analgesia, adverse reactions, changes in pulmonary and inflammatory eytokines IL-8, and TNF-α were compared. Results 6 h, 12 h, 18 h, 24 h and 48 h after surgery, VAS scores were significantly lower in the observation group than in the control group （ P 〈 0. 05 ）. In the terms of PA-aO2 and RI, they increased significantly after the treatment （ P 〈 0. 05 ）, and the increase was more pronounced in the control group than in the observation group （ P 〈 0. 05 ）. The levels of IL-8 and TNF-α were obviously higher in the control group than in the observation group （ P 〈 0. 05 ）. There was no significant difference in adverse reactions between the two groups. Conclusion Pareeoxib sodium after induction of anesthesia for preemptive analgesia can get some improved postoperative pain conditions and mild inflammatory reactions, which has an important clinical significanoe.