帕瑞昔布超前镇痛对腹腔镜子宫肌瘤剥除术患者应激因子及不良反应的影响

Effect of parecoxib preemptive analgesia on stress factors and adverse reactionsinpatients undergoing laparoscopic uterine fibroids divest technique

目的探讨帕瑞昔布超前镇痛对腹腔镜子宫肌瘤剥除术患者应激因子及不良反应的影响。方法选取2017年2月至2019年2月行腹腔镜子宫肌瘤剥除术的患者142例,分为生理盐水对照组(C组)和帕瑞昔布组(P组),每组71例。C组于麻醉诱导前15 min给予生理盐水5 mL,P组给予帕瑞昔布钠40 mg静脉注射。两组麻醉诱导和麻醉维持用药相同。记录麻醉诱导前(T1)、二氧化碳(CO2)气腹建立30 min(T2)、缝合腹膜(T3)、拔除气管插管后(T4)两组患者的血浆肾上腺素、皮质醇、血糖、白细胞介素-6(IL-6)水平,并观察术后不良反应。结果两组患者T1时血浆肾上腺素、皮质醇、血糖、IL-6水平比较,差异均无统计学意义(P>0.05);两组T2、T3、T4时各指标水平均较T1时有不同程度的上升(P<0.05),且P组均低于C组(P<0.05)。P组恶心呕吐、躁动的发生率均明显低于C组(2.82%vs.12.68%,1.41%vs.9.86%,P<0.05)。结论腹腔镜子宫肌瘤剥除术患者术前给予帕瑞昔布超前镇痛,可降低患者的应激反应,减少不良反应的发生。

Objective To explore the effect of parecoxib preemptive analgesia on stress factors and adverse reactions in patients undergoing laparoscopic uterine fibroids divest technique.Methods A total of 142 patients who underwent laparoscopic hysteromyomectomy from February 2017 to February 2019 were selected and divided into the saline control group(C group)and the parecoxib group(P group),71 cases in each group.The group C was given 5 mL of normal saline 15 min before induction of anesthesia,and the group P was given intravenous injection of parecoxib sodium 40 mg.The two groups received the same anesthesia induction and maintenance drugs.The plasma adrenaline,cortisol,blood glucose and interleukin-6(IL-6)levels were recorded at the following timepoint:before anesthesia induction(T1),30 min after establishment of carbon dioxide(CO2)pneumoperitoneum(T2),closure of the peritoneum(T3)and after removing the endotracheal intubation(T4).IL-6(IL-6)level,and observe postoperative adverse reactions.The postoperative adverse reactions were observed.Results There was no statistically significant difference in levels of plasma adrenaline,cortisol,blood glucose and IL-6between the two groups at T1(P>0.05).The levels of the above indicators at T2,T3,and T4 in the two groups were higher than those at T1(P<0.05),and levels of the above indicators in the group P were lower than those in the group C(P<0.05).The incidence rates of nausea,vomiting and restlessness in the group P were significantly lower than those in the group C(2.82%vs.12.68%,1.41%vs.9.86%,P<0.05).Conclusion In patients undergoing laparoscopic uterine fibroids divest technique,preparative analgesia with parecoxib before surgery can reduce the patient′s stress response and reduce the occurrence of adverse reactions.