| 帕瑞昔布钠对脊柱手术术后镇痛芬太尼用量的影响和安全性 |
| 投稿时间：2011-01-06 修订日期：2011-01-25 点此下载全文 |
| 引用本文：曹亲亲,周密,徐红党,李军.帕瑞昔布钠对脊柱手术术后镇痛芬太尼用量的影响和安全性[J].医学研究杂志,2012,41(1):142-145 |
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| 中文摘要:目的评价帕瑞昔布钠用于脊柱手术对术后镇痛芬太尼用量的影响及安全性。方法择期全麻下拟行脊柱手术患者60例，ASAⅠ或Ⅱ级，患者年龄23~70岁，体重50~70kg，随机分为帕瑞昔布钠组（P组，n=30）和对照组（C组，n=30）。手术结束前30min，P组静脉注射芬太尼1μg/kg和帕瑞昔布钠40mg ，C组静注芬太尼1μg/kg，两组均接上患者自控静脉镇痛（PCIA）泵。P组分别于术后8、24、36h给予帕瑞昔布钠40mg，C组不给予任何药物。记录两组术后0~12h每2h时段、12~48h时段芬太尼的消耗量及24h、48h芬太尼总消耗量，记录术后各时点静息及运动VAS评分，记录术后24h和48h患者最大疼痛缓解率、整体评价及不良反应发生情况。结果与C组相比，P组术后0~2、2~4、4~6、10~12、12~18、18~24、24~36、36~48h时段芬太尼消耗量减少（P＜0.05），术后24h和48h芬太尼总消耗量减少（28.6%和24.6%，P＜0.05）。P组术后PCAU、2、4、6、8、10、12、18、24h时点静息VAS评分，术后18、24、36、48h时点运动VAS评分均低于C组（P＜0.05），且术后24h最大疼痛缓解率及术后24h和48h患者整体评价高于C组（P＜0.05），恶心呕吐发生率低于C组（P＜0.05）。结论帕瑞昔布钠用于脊柱手术患者能减少术后镇痛的芬太尼用量并减少相关不良反应，提高术后镇痛质量，利于术后恢复。 |
| 中文关键词:帕瑞昔布钠 芬太尼 患者自控镇痛 脊柱手术 |
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| Fentanyl-sparing Effects and Safety of Parecoxib for Postoperative Analgesia Following Spinal Surgery |
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| Abstract:ObjectiveTo evaluate the effects of parecoxib for analgesic effects and consumption of fentanyl for postoperative analgesia following spinal surgery. MethodsSixty ASA ⅠorⅡ patients,aged 23-70 years,weighing 50-70kg under went general anesthesia were randomly divided into 2 groups (n=30 in each): parecoxib group (group P ) and control group (group C ). Patients in group P received intreavenous fentanyl 1μg/kg and parecoxib 40mg, or in group C received intreavenous fentanyl 1μg/kg 30 min before the end of operation and then were both attached to a PCIA pump immediately. Patients in Group P received intreavenous parecoxib 40mg at 8, 24, 36h after operation, and in group C received nothing. The intensity of pain was assessed using VAS score (0-10,0=no pain,10=worst pain).The VAS scores at rest at PACU, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48h and at moving(turing over) at 18, 24, 36, 48h after operation were recorded. The fentanyl consumption at 0-2, 2-4, 4-6, 6-8, 8-10, 10-12, 12-18, 18-24, 24-36, 36-48h and the totel amount at 24h or 48h after operation were recorded. Maximum pain relief, global evaluation rating at 24h and 48h after operation, and the incidence of adverse effects were recorded. ResultsCompared with group C, fentanyl consumption at 0-2, 2-4, 4-6, 10-12, 12-18, 18-24, 24-36, 36-48h after operation was significantly less in group P（P＜0.05）, the totel amount of fentanyl at 24h and 48h after operation was significantly less in group P（P＜0.05）and was reduced by 28.6% (at 24h) and 24.6% (at 48h) respectively. The VAS scores at rest at PACU,2, 4, 6, 8, 10, 12, 18, 24h and at moving at 18, 24, 36, 48h after operation were significantly lower in group P than in group C（P＜0.05）. Compared with group C, patients in group P experienced significantly greater maximum pain relief at 24h after operation and had significantly higher global evaluation rating at 24h and 48h after operation（P＜0.05）. The incidence of nausea and vomiting was lower in group P than in group C（P＜0.05）. ConclusionParecoxib 40mg given IV twice a day for two days can reduce the fentanyl consumption and opioid-related side-effects, improve postoperation analgesia following spinal surgery. |
| keywords:Parecoxib Fentanyl Patient-controlled analgesia Spinal surgery |
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