摘要
目的观察帕瑞昔布钠对瑞芬太尼致术后痛觉过敏(OIH)的影响,并测定其半数有效剂量(ED50)。方法择期全麻腹腔镜下行胆囊切除手术的成年患者48例,随机区组设计均分为六组,其中五组在麻醉诱导后分别静脉注射帕瑞昔布钠0.14mg/kg(P1组)、0.20mg/kg(P2组)、0.28mg/kg(P3组)、0.40mg/kg(P4组)、0.57mg/kg(P5组),另外一组注射等量生理盐水(C组)。各组均采用持续泵注瑞芬太尼0.25μg·kg-1·min-1、丙泊酚3～4mg·kg-1·h-1维持麻醉。记录患者的苏醒时间、拔管时间及清醒拔管后15min的VAS评分,用概率回归法计算帕瑞昔布钠减轻瑞芬太尼致术后OIH的ED50。结果各组患者的苏醒和拔管时间差异无统计学意义,拔管后15min P2、P3、P4、P5组VAS评分显著低于C组(P<0.05或P<0.01)。帕瑞昔布钠减轻瑞芬太尼致术后痛觉过敏的ED50是0.26mg/kg(95%可信区间:0.13～0.37mg/kg)。结论帕瑞昔布钠可减轻瑞芬太尼所致的术后OIH,其ED50是0.26mg/kg。
Objective To observe the effect and ED^0 of parecoxib on postoperative hyperalgesia after remifentanil-based anesthesia. Methods Forty-eight ASA Ⅰ or Ⅱ patients, undergoing laparoscopic cholecystectomy in general anesthesia, were randomly divided into six groups （n= 8）： They received parecoxib 0.14, 0.20, 0.28, 0.40, 0.57 mg/kg（group P1,P2,P3,P4,P5） and nonhal saline （group C） before the operation. Anesthesia was maintained with remifentanil 0.25 μg. kg^-1· min^-1 and propofol 3-4 mg. kg^-1 h^-1. The time to emergence and extubation and VAS scores （15 min after trachea extubation） were recorded. The ED50 of parecoxib on postoperative hyperalgesia was determined by probil method. Results There was no significant difference in the time to emergence and extubation in all groups. Compared with group C, VAS score was lower in group P2,P3, P4,P5 （P〈0.05 and P〈0.01）. The ED50 of parecoxib was 0.26 mg/kg （95GCI 0. 13-0.37 mg/kg）. Conclusion Parecoxib can alleviate postoperative hyperalgesia after remifentanil based anesthesia with the ED50 0 0.26 mg/kg.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2012年第8期733-735,共3页
Journal of Clinical Anesthesiology
