帕瑞昔布钠和罗帕卡因局部麻醉在妇科腹腔镜手术术后镇痛中的效果比较

Comparison of the effects of parecoxib sodium and ropivacain as local anesthesia on postoperative analgesia of gynecological laparoscopic surgery

[目的]比较帕瑞昔布钠和罗哌卡因局部麻醉在妇科腹腔镜手术术后镇痛中的效果.[方法]选择行腹腔镜妇科手术的患者60例,随机分为对照组、帕瑞昔布钠组和罗哌卡因组,每组各为20例.帕瑞昔布钠组术毕前30min静脉注射给予帕瑞昔布钠40mg,对照组静脉注射给予生理盐水,罗哌卡因组在气腹建立后腹腔内喷洒和术毕后创缘皮下注射给予0.66%(质量分数)的罗哌卡因15mL.记录术毕30min,3,6,12,24h时的视觉模拟镇痛评分(VAS评分)、Ramsay镇静评分(RS评分)、舒适度评分(BCS评分)及相关不良反应的发生率.[结果]与对照组比较,帕瑞昔布钠组和罗哌卡因组VAS评分明显降低(P<0.05),RS评分和BCS评分明显升高(P<0.05);且帕瑞昔布钠组BCS评分较罗哌卡因组明显升高(P<0.05).[结论]静脉注射给予帕瑞昔布钠及腹腔内和皮下注射给予罗哌卡因均可有效缓解妇科腹腔镜手术术后的疼痛,且术毕前静脉注射给予帕瑞昔布钠的镇痛效果更为显著.

OBJECTIVE To compare the analgesic effects of parecoxib sodium and ropivacain as local anesthesia after gynecological laparoscopic surgery.METHODS A total of 60 patients scheduled for gynecological laparoscopic surgery was randomly divided into control,parecoxib sodium and ropivacaine group,20 cases in each group.The patients in the parecoxib sodium group received 40 mg parecoxib sodium intravenously half an hour before the end of operation,while the patients in the control group received equal volume of normal saline intravenously.The patients in the ropivacaine group were administered 0.66%（mass fraction）ropivacain 15 mL intraperitoneally spraying after pneumoperitoneum or subcutaneously injecting after the end of surgery.Visual analogue scale（VAS）,Ramsay sedation scale（RS）,Bruggrmann comfort scale（BCS）and the incidence of related adverse reactions were recorded at 30 min,3,6,12and24 hafter the end of operation.RESULTS As compared with the control group,the scores of VAS reduced significantly（P〈0.05）,and the scores of RS and BCS obviously increased in the parecoxib sodium group and ropivacaine group（P〈0.05）.The scores of BCS in parecoxib sodium group increased significantly as compared with those in the ropivacain group（P〈0.05）.CONCLUSION Both intravenous injection of parecoxib sodium and intraperitoneal or subcutaneous injection of ropivacain could effectively alleviate postoperative analgesia of gynecological laparoscopic surgery,and intravenous injection of parecoxib sodium before the end of the surgery had more significant effects.