帕瑞昔布钠和酮咯酸氨丁三醇超前镇痛用于腹腔镜胆囊切除术的临床比较

Clinical Comparison of Parecoxib Sodium and Ketorolac Tromethamine Preemptive Analgesia in the Laparoscopic Cholecystectomy

目的比较帕瑞昔布钠和酮咯酸氨丁三醇用于腹腔镜胆囊切除术的临床镇痛效果。方法方便选取2016年6月—2016年10月于该院进行腹腔镜胆囊切除手术的患者共150例,随机分为3组,帕瑞昔布钠组、酮咯酸氨丁三醇组和对照组各50例。对照组在手术麻醉前静脉滴注生理盐水,帕瑞昔布钠组、酮咯酸氨丁三醇组分别于麻醉前静脉滴注帕瑞昔布钠40 mg和酮咯酸氨丁三醇30 mg。采用视觉模拟评分(VAS)对3组患者术后1、6、12、24 h进行镇痛评分,对比3组的镇痛效果,观察右肩背部疼痛的发生率。结果术后VAS评分帕瑞昔布钠组在0 h(1.25±0.37)、6 h(1.30±0.73)、12 h(1.20±0.76)和酮咯酸氨丁三醇组0 h(1.55±0.75)、6 h(1.50±0.76)、12 h(2.35±1.38)明显优于对照组0 h(2.30±1.34)、6 h(3.75±1.37)、12 h(3.60±1.53)(P<0.05),术后12 h VAS评分帕瑞昔布钠组(1.20±0.76)和酮咯酸氨丁三醇组(2.35±1.38)相比较差异有统计学意义(P<0.05)。结论帕瑞昔布钠和酮咯酸氨丁三醇超前镇痛用于腹腔镜胆囊切除术有良好的镇痛效果,且帕瑞昔布钠持续时间更长,值得推广。

Objective To compare the effect of parecoxib sodium and ketorolac tromethamine preemptive analgesia in the laparoscopic cholecystectomy. Methods 150 cases of patients with laparoscopic cholecystectomy from June 2016 to October2016 were convenient selected and randomly divided into three groups with 50 cases in each, the control group adopted the intravenous drip of normal saline before operation anesthesia, the parecoxib sodium group and ketorolac tromethamine group respectively adopted the intravenous drip of 40 mg parecoxib sodium and 30 mg ketorolac tromethamine, and the three groups were given the analgesia scoring at 1,6,12,24 h after operation by the VAS, and the analgesia effect was compared between the three groups and the incidence rate of right shoulder back pains was observed. Results The postoperative VAS scores at0 h, 6 h and 12 h in the parecoxib sodium group and in the ketorolac tromethamine group were obviously better than those in the control group[（1.25±0.37）,（1.30±0.73）,（1.20±0.76） vs（1.55±0.75）,（1.50±0.76）,（2.35±1.38） vs（2.30±1.34）,（3.75±1.37）,（3.60±1.53）]（P〈0.05）, and the difference in the postoperative 12 h VAS score between the parecoxib sodium group and ketorolac tromethamine group was statistically significance [（1.20±0.76） vs（2.35±1.38）]（P〈0.05）. Conclusion The effect of parecoxib sodium and ketorolac tromethamine preemptive analgesia in the laparoscopic cholecystectomy is good, and the duration of parecoxib sodium is longer, which is worth promotion.