复方亚甲蓝联合帕瑞昔布钠用于混合痔术后的镇痛效果

Compound methylene blue combined with parecoxib sodium for analgesia in postoperative of mixed hemorrhoids

目的:探讨复方亚甲蓝联合帕瑞昔布钠用于混合痔术后的镇痛疗效。方法:择期行PPH联合外痔切除术的混合痔患者96例,按随机数字表法分为A、B、C 3组,每组各32例。A组采用术后切口周围皮下注射复方亚甲蓝加静脉注射帕瑞昔布钠方法; B组采用术后切口周围皮下注射复方亚甲蓝法; C组采用术后静脉注射帕瑞昔布钠法。记录术后6、12、24、48、72 h疼痛(VAS)评分、身体舒适度(BCS)评分,追加的镇痛药物及恶心、呕吐、头晕、嗜睡、呼吸抑制等不良反应发生情况。结果:A组在术后6、12、24、48、72 h的VAS评分和BCS评分均优于其余两组(P <0. 05),B组的VAS评分和BCS评分在术后6、12 h与C组比较无明显差异(P> 0. 05),但B组在术后24、48、72 h优于C组(P <0. 05),A组追加的镇痛药物少于其余两组(P <0. 05),B组又少于C组(P <0. 05),3组的不良反应率比较差异无统计学意义(P> 0. 05)。结论:复方亚甲蓝联合帕瑞昔布钠用于混合痔术后能有效抑制患者术后疼痛,提高患者术后的舒适度,且不良反应少,安全性高。

Objective: To investigate the analgesia effects of compound methylene blue combined with parecoxib sodium in postoperative of mixed hemorrhoids. Methods: 96 patients with mixed hemorrhoids underwent procedure for prolapse and hemorrhoids and external hemorrhoidectomy were randomly divided into group A,group B and group C with 32 cases in each. Group A with subcutaneous injection of compound methylene blue adjacent to the surgical incision plus intravenous injection of parecoxib sodium after the operation. Group B with subcutaneous injection of compound methylene blue adjacent to the surgical incision. Group C with intravenous injection of parecoxib sodium. Visual analogue scale( VAS) pain scores and Bruggrmann comfort scale( BCS) scores and additional analgesic drugs and the incidence of adverse reactions such as nausea,vomiting,dizziness,drowsiness and respiratory depression were recorded at 6,12,24,48 and 72 h postoperatively. Results: The VAS and BCS scores of the group A were better than the other two groups at 6,12,24,48 and 72 h after operation( P < 0. 05). There was no significant difference in VAS and BCS scores between group B and group C at 6 and 12 h after operation( P > 0. 05),but the scores in group B was better than that of group C at 24,48 and 72 h after operation( P < 0. 05). The addition of analgesic drugs in group A was less than that of the other two groups( P < 0. 05),and group B was less than that in group C( P < 0. 05). There was no statistic difference in total adverse reaction rates among the three groups( P > 0. 05).Conclusion: Compound methylene blue combined with parecoxib sodium can effectively reduce postoperative pain,improve patients comfort,less adverse reaction and high safety for procedure for prolapse and hemorrhoids.