帕瑞昔布预防瑞芬太尼麻醉后痛觉过敏的观察

Observation of clinical effect of parecoxib for alleviating postoperative hyperalgesia after remifentanil-based anesthesia

目的探讨分析帕瑞昔布预防盐酸瑞芬太尼麻醉后患者痛觉过敏的临床疗效。方法将60例接受腹腔镜阑尾切除术的患者随机分为观察组和对照组,两组均为30例。观察组术前30 min静注帕瑞昔布40 mg,对照组于术前相同时间点静注生理盐水2 ml。比较两组患者不同时间点MAP与HR、拔管后VAS评分、躁动评分、Ramsay镇静评分及自主呼吸恢复时间、睫毛反射时间、睁眼时间及拔管时间。结果观察组T_1、T_2、T_3、T_4的MAP与HR均明显低于对照组;观察组拔管后VAS评分、躁动评分及Ramsay镇静评分均明显低于对照组,差异有统计学意义(P<0.05);两组自主呼吸恢复时间、睫毛反射时间、睁眼时间及拔管时间的比较差异无统计学意义(P>0.05)。结论帕瑞昔布可有效预防盐酸瑞芬太尼麻醉后患者痛觉过敏,值得临床推广。

Objective To study the clinical effect of parecoxib for alleviating postoperative hyperalgesia after remifentanil-based anesthesia. Methods 60 cases of laparoscopic appendectomy were randomly divided into observation group and control group,30 cases in each group. The observation group accepted intravenous injection of 40 mg parecoxib while the control group accepted intravenous injection of saline2 ml,30 min before the operation. MAP and HR at different time points,VAS after extubation,restlessness score,Ramsay sedation score and spontaneous breathing recovery time,eyelash reflex time,eye opening time and extubation time of the two groups were compared. Results The MAP and HR of T1,T2,T3 and T4 in the observation group were significantly lower than those of the control group; After extubation in the observation group,the VAS,the restlessness score and the Ramsay sedation score were significantly lower than those in the control group; The differences were statistically significant（P〈0.05）.There was no significant difference in the time of spontaneous breathing recovery,the time of eyelash reflex,eye opening time and extubation time between the two groups（P〉0.05）. Conclusion Parecoxib has a significant effect for alleviating postoperative hyperalgesia after remifentanil-based anesthesia,which is worth clinacal promoting.