术前口服依他昔布对妇科手术后病人自控镇痛的影响

目的: 观察妇科开腹手术患者术前给予依他昔布120 mg 对术后自控镇痛(PCA) 吗啡用量的影响及其副作用。方法: 随机选取全麻下接受妇科开腹全子宫(双附件) 切除患者40 例, 术前分别给予安慰剂或依他昔布120 mg 口服。在手术后观察24 h 患者PCA 吗啡用量, 同时记录患者的疼痛评分和满意度评分, 并观察不良反应。结果: 术后PCA 吗啡24h 消耗量在依他昔布组为9.4±7.6 mg, 显著低于安慰剂组15.7±8.9 mg。两组患者24 h 内对PCA 的按压次数依他昔布组也低于安慰剂组(P <0.05)。其中术后3、6、8 和12 h PCA 吗啡消耗量在两组间无显著差异。两组患者术后24 h 疼痛评分和对镇痛治疗的满意度也无差异。两组患者不良反应的发生率亦无差别。结论: 在妇科开腹手术患者术前应用依他昔布120 mg 可使患者术后PCA 吗啡消耗量降低, 且在术后12 h 后下降明显。未发现与依他昔布应用相关的副作用。

Effect of etoricoxib on postoperative patient-controlled analgesia in major gynecological operation

AIM: To observe the effect of preemptive etoricoxib on postoperative PCA in the major gynecological surgery.METHODS: 40 patients who underwent major gynecological surgery were selected randomly to receive placebo or etoricoxib 120 mg before surgery.The PCA morphine consumption in 24 hours was recorded and patients'satisfaction was evaluated by 0-10 scores.At the same time, side effects were also recorded.RESULTS: Postoperative 24 hours PCA morphine consumption in etoricoxib group was 9.4±7.6 mg, and it was significant lower than which in placebo group 15.7±8.9 mg.The overall PCA attempts was also lower in etoricoxib group than in placebo group(P <0.05).The first 6 hours and first 12 hours morphine consumption of PCA had no significant difference between two groups.There were no significant differences of patients'satisfaction and side effects rates between two groups.CONCLUSION: The preemptive etoricoxib 120mg in major gynecological surgery may decrease postoperative PCA morphine consumption, especially 12 hours after operation.Patients'satisfaction score have no improvements and no significant side effects caused by etoricoxib were found.