帕瑞昔布钠超前镇痛对肺挫伤手术患者术后镇痛及肺功能的影响

Effects of Preemptive Analgesia with Parecoxib Sodium on Postoperative Analgesia and Pulmonary Function in Patients with Pulmonary Contusion Surgery

目的分析帕瑞昔布钠超前镇痛对肺挫伤手术患者术后镇痛及肺功能的影响。方法选取2019年1月至2021年1月临沂市中心医院收治的102例肺挫伤患者作为研究对象,根据不同干预方法分为对照组(42例)和观察组(60例)。其中,观察组麻醉诱导前15 min静脉注射40 mg注射用帕瑞昔布钠(以0.9%氯化钠溶液∶注射用帕瑞昔布钠=1 ml∶9 mg的比例溶解帕瑞昔布钠),对照组同一时间点静脉注射与观察组等量的0.9%氯化钠溶液,两组均予以静脉麻醉及术后静脉自控镇痛。比较两组患者术后镇痛效果[视觉模拟评分法(VAS)评分]、肺功能指标[肺泡-动脉氧分压差(PA-aO_(2))、呼吸指数(RI)]及不良反应发生情况。结果VAS评分组间、时点间的主效应差异有统计学意义(P<0.01),组间与时点间存在交互作用(P<0.01)。术后不同时间点两组的VAS评分均先升高后降低(P<0.05),且观察组均低于对照组(P<0.05)。PA-aO_(2)和RI组间、时点间的主效应差异有统计学意义(P<0.01);组间与时点间存在交互作用(P<0.01)。术后不同时间点两组的PA-aO_(2)和RI均下降(P<0.05),且观察组均低于对照组(P<0.05)。观察组的总不良反应发生率为11.67%(7/60),对照组为19.05%(8/42),两组的总不良反应发生率比较差异无统计学意义(P>0.05)。结论肺挫伤手术患者应用帕瑞昔布钠超前镇痛,不仅可缓解患者术后疼痛,保护患者肺功能,而且安全性高。

Objective To analyze the effect of parecoxib sodium preemptive analgesia on postoperative analgesia and pulmonary function in patients with pulmonary contusion surgery.Methods A total of 102 patients with pulmonary contusion admitted to Linyi Central Hospital from Jan.2019 to Jan.2021 were included,and divided into a control group(42 cases)and an observation group(60 cases)according to different intervention methods.In the observation group,40 mg of parecoxib sodium for injection(0.9%sodium chloride solution:parecoxib sodium for injection=1 ml∶9 mg)was injected intravenously 15 minutes before anesthesia induction,while in the control group,the same amount of 0.9%sodium chloride solution was injected intravenously at the same time point as in the observation group,and both groups were given intravenous anesthesia and postoperative patient-controlled intravenous analgesia.The postoperative analgesic effect[visual analogue scale(VAS)score],pulmonary function indicators[alveolar-arterial oxygen partial pressure difference(PA-aO_(2))and respiratory index(RI)]and the incidence of adverse reactions were compared between the two groups.Results There were significant differences in the main effect of VAS score between groups and time points(P<0.01),and there was an interaction between groups and time points(P<0.01).The VAS scores of the two groups at different time points after operation first increased and then decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The main effect differences in PA-aO_(2) and RI between groups and between time points were statistically significant(P<0.01);there were interactions between groups and time points(P<0.01).The PA-aO_(2) and RI of the two groups decreased at different time points after operation(P<0.05),and the observation group was lower than the control group(P<0.05).The incidence of total adverse reactions in the observation group was 11.67%(7/60)and that in the control group was 19.05%(8/42),and there was no significant difference between the two groups(P>0.05).Conclusion The application of parecoxib sodium preemptive analgesia in patients with pulmonary contusion surgery not only can relieve postoperative pain and protect the lung function of the patients,but also has high safety.