喷他佐辛复合帕瑞昔布钠预防妇科开腹手术瑞芬太尼麻醉术后痛觉过敏的效果

Effect of pentazocine combined with parecoxib sodium on prevention of hyperalgesia after remifentanil anesthesia in gynecological open surgery

目的探讨喷他佐辛复合帕瑞昔布钠在预防妇科开腹手术瑞芬太尼麻醉术后痛觉过敏中的临床效果。方法选取2018年5月至2020年5月于我院接受妇科开腹手术的78例患者为研究对象,所有患者均行气管插管全身麻醉。根据随机抽样法将患者分为对照组和研究组,各39例。对照组应用帕瑞昔布钠,研究组应用喷他佐辛复合帕瑞昔布钠。比较两组患者的术后不同时间的镇静及镇痛效果、术后舒适度、麻醉相关指标及不良反应发生率。结果研究组拔管即刻及术后0.5 h的Ramsay评分均高于对照组,差异具有统计学意义(P<0.05);两组患者术后1 h的Ramsay评分比较,差异无统计学意义(P>0.05)。两组患者拔管即刻及术后0.5、1 h的VAS评分比较,差异无统计学意义(P>0.05)。研究组拔管即刻及术后0.5、1 h的BCS舒适度评分高于对照组(P<0.05)。两组患者的MAP与HR无显著差异(P>0.05);研究组的拔管时间、苏醒时间短于对照组,镇痛药追加次数少于对照组,差异具有统计学意义(P<0.05)。研究组的恶心呕吐、呼吸抑制、头晕的发生率均低于对照组(P<0.05)。结论喷他佐辛复合帕瑞昔布钠可有效提高妇科开腹手术患者的术后舒适度,预防术后痛觉过敏,镇痛安全性高,且麻醉恢复快,值得临床应用推广。

Objective To investigate the clinical effect of pentazocine combined with parecoxib sodium on prevention of hyperalgesia after remifentanil anesthesia in gynecological open surgery.Methods Seventy-eight patients who underwent gynecological open surgery in our hospital from May 2018 to May 2020 were selected as the research objects,and all patients received general anesthesia through tracheal intubation.According to random sampling method,the patients were divided into control group and study group,with 39 cases in each group.The control group was given parecoxib sodium,and the study group was given pentazocine combined with parecoxib sodium.The sedative and analgesic effects,postoperative comfort at different time after operation,anesthesia related indexes and the incidence of adverse reactions were compared between the two groups.Results The Ramsay score at extubation and 0.5 h after operation in the study group were higher than those in the control group,the differences were statistically significant(P<0.05);there was no significant difference in Ramsay score at 1 h after operation between the two groups(P>0.05).There were no significant differences in VAS score between the two groups at extubation and 0.5 and 1 h after operation(P>0.05).The BCS comfort score at extubation and 0.5 and 1 h after operation of the study group were higher than those of the control group(P<0.05).There were no significant differences in MAP and HR between the two groups(P>0.05);the extubation time and recovery time of the study group were shorter than those of the control group,and the number of additional analgesics was less than that of the control group,the differences were statistically significant(P<0.05).The incidences of nausea and vomiting,respiratory depression and dizziness in the study group were lower than those in the control group(P<0.05).Conclusion Pentazocine combined with parecoxib sodium can effectively improve the postoperative comfort of patients with gynecological open surgery,prevent postoperative hyperalgesia,with high analgesic safety and rapid recovery of anesthesia,which is worthy of clinical application and promotion.