酮咯酸氨丁三醇和帕瑞昔布钠在骨折术后的镇痛效果比较

Comparison of ketorolac ammonia butyl alcohol three and parecoxib sodium on postoperative analgesic effect of fracture

目的研究酮咯酸氨丁三醇和帕瑞昔布钠在骨折围手术期应用的镇痛疗效比较,评估2种药物的临床使用价值。方法选取我科2015年1月-2015年8月行骨折(单纯四肢长骨骨折)择期手术患者164例,164例骨折术后患者随机分成两组;A组给予酮咯酸氨下三醇,B组给予帕瑞昔布钠。所有患者术后72h给药,观察术后第1d、第2d、第3d的数字评估分量表NRS最高值评分并作为当天的疼痛强度、盐酸哌替啶消耗量、恶心呕吐不良反应发生情况。结果 A组酮咯酸氨丁三醇组患者和B组帕瑞昔布组患者在骨折术后第1天NRS评分分别为(2.83±0.98;2.85±1.01),2组疼痛评分均无明显差异(t=-0.157,P=0.875);第2天NRS评分分别为(2.49±0.86;2.56±0.90)2组疼痛评分均无明显差异(t=-0.530,P=0.597);第3天NRS评分别为(2.12±0.74;2.29±0.75),2组疼痛评分均无明显差异(t=-0.839,P=0.403)。但2组疼痛NRS评分在术后72h均逐渐降低,说明2组镇痛药均有效。2组术后3d盐酸哌替啶消耗量分别为(Z=-0.204,P=0.810;Z=-0.964,P=0.335;Z=-0.581,P=0.561),2组统计学比较均无明显差异。2组术后72h恶心呕吐不良反应比较无显著性差异(P=0.367)。结论骨折术后3d使用酮咯酸氨丁三醇(60mg qd静脉泵)和帕瑞昔布钠(40mg bid肌肉注射)均可以较好地改善镇痛效果,效果确切,不良反应少,二者均无明显差别,并减少了传统阿片类药物的使用,是值得临床推广使用的2种注射性NSAID药物。

Objective A comparative study of ketorolac ammonia butyl alcohol three and parecoxib sodium in peri operative analgesia effect of fracture application, clinical value evaluation of two kinds of drugs.Methods In our hospital from January 2015 to August 2015 for fracture(simple bone fracture) 164 cases of patients undergoing elective surgery, 164 cases of fracture patients were randomly divided into two groups; A group received ketorolac three alcohol, B group received parecoxib sodium. All patients were given 72 hours after surgery, and the maximum score of NRS score on the first, second and third days after operation was observed. The scores of pain intensity,consumption of pethidine hydrochloride and adverse reactions of nausea and vomiting were recorded as the same day.Results A group of ketorolac ammonia butyl alcohol three groups group B and parecoxib group in patients with fracture of the first postoperative day NRS scores were(2.83±0.98;2.85±1.01), there were no significant difference between the two groups of pain scores(t=-0.157,P=0.875); second days NRS scores were(2.49 ±2.56 ±0.86;0.90)there were no significant difference between the two groups of pain scores(t=-0.530, P=0.597); the NRS score is third days(2.12±0.74;2.29±0.75), there were no significant difference between the two groups of pain scores(t=-0.839,P=0.403). But the NRS scores of the two groups decreased gradually 72 hours after the operation, indicating that the two groups of analgesics were effective. The consumption of pethidine in the two groups was 3 days after operation(Z=-0.204, P=0.810; Z=-0.964, P=0.335; Z=-0.581, P=0.561), and there was no significant difference between the two groups. There was no significant difference in nausea and vomiting at 72 hours after operation between the two groups(P=0.367).Conclusion Fracture after 3 days using ketorolac ammonia butyl alcohol three(60 mg QD venous pump) and parecoxib sodium(40 mg bid injection) all can improve the analgesic effect, exact effect, less adverse reaction, both of which had no significant difference, and reduces the use of traditional opioid drugs, two kinds of injection NSAID drug is worthy of clinical use.