摘要
目的观察帕瑞昔布（特耐）结合切口局麻用于腹腔镜胆囊切除术后的镇痛效果。方法选择全麻下行腹腔镜胆囊切除术患者50例，按随机数字表随机双盲分为特耐组和对照组，每组25例。术前10min实验组静注特耐40mg，对照组静注同等容量的生理盐水。所有病例均于切皮前在脐部切口处以0．375％布比卡因8ml全层浸润。观察时间点为：T1（离开麻醉后恢复室时），T2（术后5h）和T3（手术次日晨）。比较两组患者视觉模拟评分法（visualanaloguescale／score，VAS）值、是否要求额外给予阿片类药物镇痛、整体镇痛质量的满意认可及对睡眠质量的满意认可。结果在T1、T2时间点，特耐组的VAS显著低于对照组（T1：1．6＋0．5VS3．6＋0．7，T2：1．8＋0．6VS3．5＋0．9，P〈0．05）；在T3特耐组的VAS评分略低于对照组，但差异无统计学意义。对照组要求病房医生予以镇痛治疗者显著多于特耐组（11 vs 2，P〈0．05），对整体镇痛质量的满意率（82％ VS 52％）和睡眠质量满意率（86％VS61％）在特耐组均显著高于对照组（P〈0．05）。结论特耐联合切口局部浸润麻醉在腹腔镜胆囊切除术后可以提供良好的镇痛效果．
Objective To investigate the postoperative analgesic effect of parecoxib following laparoscopic cholecystectomy when local anesthetics was infiltrated at incision site. Methods Fifty patients undergoing laparoscopic cholecystectomy were randomized into two groups in a double-blind manner： patients in the experimental group received intravenous parecoxib 40 mg 10 min before operation, and patients in the control group received intravenous normal saline in same volume. All the patients received incision infiltration with 0.375% bupivacaine 8ml at navel before the operations. The observation time points included T1 （departure from the PACU）, T2 （5 h after the operation） and T3 （the morning of postoprative day 1 ）. VAS values, additional requirement of opioids analgesia, the rate of satisfactory with analgesia quality and sleep quality was compared between two groups. Results The VAS values in the experimental group were significantly lower than that in the control group at time point T1 and T2 （TI： 1.6±0.5 vs 3.6±0.7, T2：1.8±0.6 vs 3.5±0.9, P〈0.05）, while VAS was lower in the experimental group at T3, but the difference had no Statistical significance. The rate of satisfactory with analgesia and sleep quality in the experimental group was significantly higher than that in the control group. Conclusion Paricoxib combined with local anesthetics infiltration can significantly relieve the postoperative pain in the patients receiving laparoscopic cholecystectomy.
出处
《国际麻醉学与复苏杂志》
CAS
2011年第4期417-418,423,共3页
International Journal of Anesthesiology and Resuscitation
