帕瑞昔布钠联合羟考酮对乳腺癌患者镇痛效果及应激反应的影响

The influence of parecoxib sodium combined with oxycodone on analgesic effect and stress response in patients with breast cancer

目的探讨帕瑞昔布钠联合羟考酮对乳腺癌患者镇痛效果及应激反应的影响。方法选择2017年1月—2018年6月本院收治的46例乳腺癌患者为研究对象,均接受乳腺癌根治术治疗,根据随机数字表法分为观察组与对照组两组,每组各23例。对照组予羟考酮0.10 mg/kg镇痛,观察组则应用帕瑞昔布钠40 mg联合羟考酮0.10 mg/kg镇痛,比较两组患者麻醉前(T0)、术后2 h(T1)、术后12 h(T2)、术后24 h(T3)及术后48 h(T4)血浆肾素、醛固酮、皮质醇浓度,并比较镇痛效果(VAS评分)。结果观察组患者VAS评分在T2、T3、T4时间点分别为(1.97±0.58)分、(2.61±0.82)分、(1.44±0.43)分,明显低于对照组患者的(3.72±1.39)分、(4.12±1.46)分、(2.69±0.79)分,差异有统计学意义(P<0.05);观察组患者中,血浆肾素、醛固酮、皮质醇浓度在T2、T3时间点浓度分别为(0.57±0.18) ng/ml和(0.61±0.22) ng/ml、(224.3±25.3) ng/ml和(221.1±21.6) ng/ml、(224.3±25.3) ng/ml和(261.1±20.8) ng/ml,明显低于对照组的(0.72±0.22) ng/ml和(0.82±0.29) ng/ml、(259.2±26.4) ng/ml和(265.8±28.8) ng/ml、(299.2±27.2) ng/ml和(295.8±24.5) ng/ml,差异均有统计学意义(P<0.05)。结论乳腺癌根治术患者术中应用帕瑞昔布钠联合羟考酮,可以有效镇痛,同时抑制应激反应。

Objective To investigate the impact of parecoxib sodium combined with oxycodone on pain relief and stress response in patients with breast cancer.Methods Forty-six cases of patients with breast cancer admitted to our hospital from January 2017 to June 2018 were selected as the study subjects.All patients received breast cancer radical mastectomy.According to the random number table method,they were divided into observation group and control group,23 patients in each group.The control group was given oxycodone(0.1mg/kg)for analgesia,while the observation group was given parecoxib sodium(40mg)combined with oxycodone(0.1mg/kg)for analgesia.The plasma renin,aldosterone and cortisol concentrations before anesthesia(T0),2 hours(T1),12 hours(T2),24 hours(T3)and 48 hours(T4)after anesthesia were compared between the two groups.And the analgesic effects were compared(VAS score).Results The VAS scores of observation group at T2,T3 and T4 were(1.97±0.58),(2.61±0.82)and(1.44±0.43),respectively.It was significantly lower than those of the control group(3.72±1.39,4.12±1.46,and 2.69±0.79),the differences were statistically significant(P<0.05).In the observation group,concentration of plasma rennin and(0.57±0.18 ng/ml and 0.61±0.22 ng/ml),aldosterone(224.3±25.3 ng/ml and 221.1±21.6 ng/ml)and cortisol(224.3±25.3 ng/ml and 261.1±20.8ng/ml)at time point T2 and T3 were significantly lower than those of the control group(0.72±0.22 ng/ml and 0.82±0.29 ng/ml,259.2±26.4 ng/ml and 265.8±28.8 ng/ml,299.2±27.2 ng/ml and 295.8±24.5 ng/ml),P<0.05.Conclusions The combination of parecoxib sodium and oxycodone could effectively relieve pain and inhibit stress response in patients undergoing breast cancer radical mastectomy.