帕瑞昔布钠或酮咯酸氨丁三醇复合地佐辛对腰椎手术后镇痛效果影响的临床观察

Clinical observation on the efficacy of parecoxib or ketorolac combined with dezocine on patient-controlled analgesia for management of pain after lumbar surgery

目的观察帕瑞昔布钠或酮咯酸氨丁三醇复合地佐辛在腰椎融合手术后患者自控静脉镇痛(PCIA)中的应用效果。方法选择全麻下腰椎后路融合术后患者90例,随机分为帕瑞昔布钠(P组),酮咯酸氨丁三醇组(K组)和对照组(C组),分别于切皮前30 min、接PCA后24 h和48 h时静注帕瑞昔布钠、酮咯酸氨丁三醇和生理盐水。记录术后1 h、6 h、24 h、48 h、72 h的VAS评分、Ramsay镇静评分、PCA泵按压总次数、使用哌替啶例数、不良反应以及伤口引流量。结果 P组和K组患者术后1 h和6 h VAS评分、PCA按压总次数以及使用哌替啶例数以及术后1 h、6 h、24 h时点Ramsay评分均低于C组(P<0.05),而P组与K组间上述指标无显著差异(P>0.05)。结论帕瑞昔布钠或酮咯酸氨丁三醇复合地佐辛用于腰椎融合术后患者自控静脉镇痛,效果良好,不良反应少。

Objective To observe the effect of parecoxib or ketorolac combined with dezocine for patient con加lied intravenous analgesia （PCIA） after lumbar fixation surgery. Methods Ninety patients after lumbar fixation surgery were recruited in this study. All these patients were divided into three groups, group P, group K and group C. Patients in group P received parecoxib, patients in group K received ketorolac, and patients in group C received intravenous infusion of saline in 30 min before skin incision, or 24 h and 48 h after using PCIA. The visual analogue scores （ VAS） , Ramsay scores, total number of pressing PCA pump, number of cases using dolantine, side effects and output of drainage were recorded at the time points oflh,6h,24h,48h and 72 h after the operation. Results The VAS scores, total number of pressing PCA pump and cases of using dolantine were significantly lower in group P and group K than those of group C （ P 〈 0. 05） , but there was no significant difference between P and K groups （ P 〉0.0 5） . Conclusion Parecoxib or ketorolac combined with dezocine were effective and safe in PCIA after lumbar fixation surgery.