帕瑞昔布钠联合自控静脉镇痛在胸外科手术麻醉中的应用

Application of Paroxicib Sodium Combined with Patient-Controlled Intravenous Analgesia in Thoracic Surgery Anesthesia

目的在胸外科手术麻醉中联合应用自控静脉镇痛+帕瑞昔布钠,并分析其应用价值。方法选取2021年3月—2022年3月在本院胸外科进行手术治疗的62例患者,并将其随机分为观察组、对照组,每组31例。两组均应用静脉复合全麻,术后应用自控静脉镇痛(舒芬太尼),在此基础上,观察组联用帕瑞昔布钠。比较两组的疼痛程度[视觉疼痛模拟评分(VAS)]、舒芬太尼使用剂量、自控镇痛(PCA)次数、炎症因子水平[白细胞介素-6(IL-6)、前列腺素E2(PGE2)、肿瘤坏死因子ɑ(TNF-α)]、镇痛满意度及不良反应等指标。结果观察组患者术后6h、24h、48h的VAS评分均低于对照组,且舒芬太尼使用剂量低于对照组,24h内PCA次数低于对照组,均差异明显有统计学意义(P<0.05);术后2h、24h,观察组患者PGE2、IL-6、TNF-ɑ水平均显著低于对照组(P<0.05);观察组患者镇痛满意度明显高于对照组,不良反应率明显低于对照组,均差异明显有统计学意义(P<0.05)。结论与单纯自控静脉镇痛相比,联合应用帕瑞昔布钠能够提高镇痛效果,减少麻醉药物使用剂量,下调炎症因子水平,患者的镇痛满意度更高,且不良反应更少。

Objective To analyze application value of patient-controlled intravenous analgesia combined with paroxycoxib sodium in thoracic surgery anesthesia.Methods The paper chose 62 patients with surgical treatment in thoracic surgery department of our hospital from March 2021 to March 2022,and divided them into observation group and control group randomly,with 31 cases in each group.Both groups were treated with intravenous combined general anesthesia and postoperative patient-controlled intravenous analgesia(sufentanil).On the basis,observation group was combined with paroxycoxib sodium.Pain degree[visual pain simulation scores(VAS)],sufentanil dosage,times of patient-controlled analgesia(PCA),inflammatory factor levels[interleukin-6(IL-6),prostaglandin E2(PGE2),tumor necrosis factorɑ(TNF-α)],satisfaction degree with pain relief and adverse reactions was compared.Results VAS scores of observation group at 6h,24h,and 48h after surgery were lower than control group,dosage of sufentanil was lower than control group.Number of PCAs within 24h was lower than control group,with significant difference(P<0.05).2h and 24h after surgery,PGE2,IL-6,TNF-ɑ levels in observation group were significantly lower than control group(P<0.05).Satisfaction degree of pain relief in observation group was,significantly higher than in control group,adverse reaction rate was,significantly lower than in control group,with significant difference(P<0.05).Conclusion Compared with patient controlled intravenous analgesia alone,combination of parecoxib sodium can improve analgesic effect,reduce dosage of narcotic,and reduce level of inflammatory factors,with higher satisfcation degree with analgesia and fewer adverse reactions.