帕瑞昔布钠用于鼻内镜手术术后镇痛疗效评价

目的观察帕瑞昔布钠用于鼻内镜手术术后镇痛的镇痛效果和安全性。方法选择ASAⅠ～Ⅱ鼻内镜手术患者90例,随机分为帕瑞昔布钠组(A组)术毕前15min静注帕瑞昔布钠40mg、曲马多组(B组)术毕前15min静注曲马多40mg和生理盐水组(C组)术毕前15分钟静注等量生理盐水,每组各30例。监测血流动力学,比较术毕即刻(T0)、拔管前5min(T1)、拔管即刻(T2)、拔管后5min(T3)血压、心率、SpO2变化。比较术后2h、4h、8h、12h和24hVAS和BCS评分及不良反应。结果 A组T1、T3各时点SP、DP、MAP、HR低于B组(P<0.05),T1、T3各时点SP、DP、MAP、HRC组均高于A组和B组(P<0.05),与T0时点比较,B组和C组T1、T2、T3时点SP、DP、MAP、HR明显升高(P<0.05)。T3时点SpO2C组均低于A、B两组,P<0.05,但其值均在97%以上,无临床意义。VAS评分术后2h、4h、8h、12h各时点A组低于B组(P<0.05),B组低于C组P<0.05);BCS评分:术后2h、4h、8h各时点A组高于B组(P<0.05),B组高于C组(P<0.05);不良反应比较:B组恶心、呕吐率高于A、C两组(P<0.05)。结论帕瑞昔布钠用于鼻内镜术后镇痛效果确切,不良反应少。

Clinial efficacy of parecoxib sodium on the postoperative analgesia of nasal endoscope surgery

Objective To study the efficacy and safety of parecoxib sodium for postoperative analgesia of nasal endoscopic surgery. Methods Ninety ASAⅠ～Ⅱ patients undergoing nasal endoscopic surgery were randomly divided into three groups, each with 30 cases. Parecoxib sodium group (group A) were injected intravenously with 40 mg parecoxib sodium 15 minutes before operation; Teamadol group (group B) were injected intravenously with 40 mg Teamadol hydrochloride at the same time; saline group (group C) were injected intravenously with equivalent saline at the same time. Hemodynamies were observed, and the blood pressure, heart rate and pulse oxygen saturation were compared between the there groups at the end of operation (T 0 ), 5 minutes before extubation (T 1 ), at the extubation (T 2 ), and 5 minutes after extubation (T 3 ). The postoperative analgesic effects were evaluated with VAS and BCS scores as well as adverse effects at 2 h, 4 h, 8 h, 12 h, and 24 h after surgery. Results At T 1 and T 3 , SP, DP, MAP, HR were significantly lower in group A than group B (P<0.05), and those in group B was significantly lower than those in group C (P<0.05). SD, DP, MAP, HR in group B and group C were increased significantly at the T 1 ,T 2 ,T 3 , compared with those at T0 (P<0.05). The levels of SpO 2 was lower in group C than of group A and group B at T 3 (P<0.05), but the levels were all more than 97%, with no clinical significance. VAS scores were significantly lower in group A than group B at 2 h, 4 h, 8 h, and 12 h after surgery (P<0.05), and the scores were significantly lower in group B than group C (P<0.05). BCS scores were significantly higher in group A than group B at 2 h, 4 h, and 8 h after surgery (P<0.05), and the scores were significantly higher in group B than group C (P<0.05). The incidence of adverse effects were significantly higher in Group B than group A and group C (P<0.05). Conclusion Parecoxib sodium is quite effective for postoperative analgesia of nasal endoscopic surgery, with less adverse effects.