摘要
目的探讨帕瑞昔布钠用于妇科手术超前镇痛对术后芬太尼静脉镇痛效果的影响。方法择期妇科手术患者90例,随机分为两组:实验组手术缝皮前和术后12 h分别静脉推注帕瑞昔布钠40 mg(生理盐水稀释5 ml),对照组静脉推注生理盐水5 ml。术毕两组均给予患者自控的静脉镇痛泵术后镇痛(PCIA),镇痛药配方为芬太尼1 mg,稀释至100 ml,首次量为5 ml,背景流量2 ml/h,追加量2 ml,锁定时间15 min。记录术后24 h内镇痛评分(VAS)、镇静评分(Ramsay)、不良反应及术后镇痛满意度。结果实验组患者术后1 h、12 h VAS评分显著低于对照组(P<0.05),而两组间Ramsay镇静评分差异无统计学意义(P>0.05)。实验组术后24 h内PCA的按压次数显著低于对照组(P<0.01),对照组患者在PCA期间各不良反应的发生率高于实验组(P<0.01)。两组患者术后满意度比较差别无统计学意义(P>0.05)。结论妇科患者使用帕瑞昔布钠超前镇痛,可明显减少芬太尼的用量和不良反应的发生率,提高镇痛质量。
Objective To observe the effect of intravenous push parecoxib sodium on the analgesic effect of fentanyl after gynecological surgery. Methods Ninety patients undergoing gynecologic surgery were randomized equally into two groups to receive postoperative patient controlled intravenous analgesia（ PCIA ）. Experimental group：parecoxib sodium 40 mg（ saline dilute to 5 ml） was injected into vein before skin closure and 12 h after the operation. Control group：replace drug with saline（5 ml）. Both groups receive PCIA with fentanyl（1 mg dilute to 100ml） at the PCIA rate of 2 ml/h,first dose of 5 ml,bolns dose of 2 ml,and lock time of 15 min. the analgesic effect was evaluated with the visual analogue score（VAS）, Ramesay calm Score, adverse reaction and postoperative analgesia degree of satisfaction. Results At the point of 1 h and 12 h hour,VAS score of the experimental group was significantly lower than that of the control group（ P 〈 0.05 ）. Ramsay calm score had not significant differences between the two groups（ P 〉 0.05 ）. The total PCA demand times in experimental group were significantly lower than that in control group （P 〈0.05 ）. The rate of untoward effect in the control was significantly higher than that of the experimental group（ P 〈 0.01 ） during PCIA. The satisfaction degree of patients had no statistical significance between the two groups（ P 〉 0.05 ）. Conclusion The postoperative analgesia with parecoxib sodium combined with fentanyl can significantly reduce fentanyl dose and the incidence of adverse effects associated with fentanyl, and improve the effect of analgesia.
出处
《中华全科医学》
2011年第1期54-55,共2页
Chinese Journal of General Practice
关键词
帕瑞昔布钠
芬太尼
妇科手术
术后镇痛
Pareeoxib sodium
Fentanyl
Gynecological operation
Postoperative analgesia
