帕瑞昔布钠联合超声引导腹横肌平面阻滞对妇科腹腔镜手术后镇痛效果的影响

Effect of parecoxib sodium combined with ultrasound guided transversus abdominis plane block on efficacy of analgesia after gynecological laparoscopic surgery

目的：评价帕瑞昔布钠联合超声引导腹横肌平面（TAP）阻滞用于妇科腹腔镜手术后的镇痛效果。方法选择在全身麻醉下行腹腔镜全子宫切除术患者60例，年龄45～65岁，体质量53～72 kg，ASA分级Ⅰ或Ⅱ级，按随机数字表法分为帕瑞昔布钠联合超声引导TAP阻滞组（帕瑞昔布钠组）和单独超声引导TAP阻滞组（对照组），每组30例，两组均在全身麻醉气管插管后进行超声引导TAP阻滞。帕瑞昔布钠组在手术开始后静脉注射帕瑞昔布钠40 mg，对照组为相同容量的0.9％氯化钠。记录两组手术时间、疼痛视觉模拟量表（VAS）评分、舒适度量表（BCS）评分。结果帕瑞昔布钠组在术后4、8、24 h VAS评分明显低于对照组[（0.9±0.2）分比（1.9±0.4）分、（1.1±0.4）分比（2.7±0.2）分、（1.3±0.3）分比（3.1±0.2）分]，差异有统计学意义（P＜0.05）。帕瑞昔布钠组在术后4、8、24 h BCS评分明显高于对照组[（2.9±0.4）分比（2.2±0.3）分、（2.8±0.3）分比（1.9±0.4）分、（2.6±0.5）分比（1.7±0.4）分]，差异有统计学意义（P＜0.05）。结论帕瑞昔布钠联合超声引导TAP阻滞在妇科腹腔镜手术后可以提供良好的镇痛效果。

Objective To evaluate the efficacy of parecoxib sodium combined with ultrasound guided transversus abdominis plane （TAP） block for analgesia after gynecological laparoscopic surgery. Methods Sixty patients （45 to 65 years old, 53- 72 kg and ASA gradeⅠorⅡgrade） who had underwent general anesthesia in laparoscopic hysterectomy were randomly divided into parecoxib group and control group, with 30 cases in each group two groups were in general anesthesia after tracheal intubation in. The ultrasound guided TAP block was performed in all patients after tracheal intubation in general anesthesia. After the operation, the control group was intravenously injected with 40 mg parecoxib sodium, and the control group was given 0.9%sodium chloride of the same volume. Operation time, pain visual scale （VAS） scores and body comfort scale （BCS） scores were recorded and compared. Results The levels of VAS scores in parecoxib sodium group were significantly lower than those in control group after 4, 8 and 24 h： （0.9 ± 0.2） scores vs. （1.9 ± 0.4） scores, （1.1 ± 0.4） scores vs. （2.7 ± 0.2） scores, （1.3 ± 0.3） scores vs. （3.1 ± 0.2） scores, and there were significant differences （P〈0.05）. The levels of BCS scores in parecoxib sodium group were significantly higher than those in control group after 4, 8 and 24 h： （2.9 ± 0.4） scores vs. （2.2 ± 0.3） scores, （2.8 ± 0.3） scores vs. （1.9 ± 0.4） scores, （2.6 ± 0.5） scores vs. （1.7 ± 0.4） scores, and there were significant differences （P〈0.05）. Conclusions Parecoxib sodium combined with ultrasound guided TAP block for analgesia after gynecological laparoscopic surgery can provide a good analgesic effect.