胰腺手术患者围术期应用环氧化酶2抑制剂超前镇痛的术后镇痛效果

Outcomes of preemptive analgesia with COX-2 inhibitors used perioperatively in patients undergoing pancreatic surgery

目的探讨胰腺手术患者围术期应用环氧化酶2(COX-2)抑制剂超前镇痛的术后镇痛效果。方法 120例胰腺手术患者按照年龄、性别和是否饮酒1∶1配对分为两组:超前镇痛组围术期采用COX-2选择性抑制剂行超前镇痛;对照组不用超前镇痛。分层分析两组患者术后3d的疼痛缓解情况。结果胰腺术后超前镇痛组疼痛较对照组轻(P<0.05)。按年龄、性别、是否饮酒分组,发现年龄≤55岁、女性、未饮酒患者在使用超前镇痛后能够有效缓解术后疼痛(P<0.05),而年龄>55岁、男性、饮酒患者在使用超前镇痛后未能有效缓解术后疼痛。结论应用COX-2抑制剂超前镇痛能有效缓解年龄≤55岁、女性和无饮酒史的胰腺手术患者的术后疼痛。

Objective To investigate the outcomes of preemptive analgesia with cyclooxygenase-2 （COX-2） inhibitors used perioperativelY in patients undergoing pancreatic surgery. Methods A total of 120 patients undergoing pancreatic operations was equally matched into two groups of A（treated with perioperative preemptive analgesia of COX-2 inhibitors） and B（without perioperative preemptive analgesia） according to age, gender and drinking status. The pain in postoperative three days was evaluated and a stratification analysis of postoperative pain relief was performed. Results Postopera- tive pain was much slighter in group A than that in group B（P〈0. 05）. The patients aged no more than 55 years, female or without a history of alcohol drinking accepted preemptive analgesia could effectively relieve pain after operation（P〈0. 05） ,while those aged more than 55 years,male or with a history of alcohol drinking could not effectively relieve pain. Conclusion Perioperative use of COX-2 inhibitors for preemptive analgesia can effectively attenuate postoperative pain of the patients undergoing pancreatic surgery who were aged no more than 55 years old, female and without a history of alcohol drinking