摘要
目的观察帕瑞昔布超前镇痛对拟行胃癌根治术患者炎症因子及应激反应的影响。方法 40例拟行胃癌根治术患者随机分为试验组和对照组,每组20例,两组麻醉方法相同。患者自控镇痛(PCA)泵中镇痛药为吗啡1 mg.mL-1,术毕即连接PCA泵。试验组麻醉诱导后静脉注射(静注)首剂帕瑞昔布40 mg,对照组于术毕即刻静注首剂帕瑞昔布40 mg,均于术后12、24和36 h注射帕瑞昔布40 mg。术后6、12、24、36和48 h评价安静痛和咳嗽痛视觉模拟评分(VAS);记录PCA有效按压次数及药物用量;于麻醉前、手术结束时、术后12 h及24 h测定血白细胞介素6(IL-6)、IL-8、肿瘤坏死因子α(TNF-α)、皮质醇及血管紧张素Ⅱ(ATⅡ)浓度。结果 PCA镇痛开始后6 h试验组安静痛和咳嗽痛VAS评分均低于对照组,有显著差异(P<0.05);试验组患者有效按压次数及药物用量亦低于对照组(P<0.05)。手术结束至术后24 h试验组患者IL-6、TNF-α、皮质醇及ATⅡ水平均低于对照组,差异有显著意义(P<0.05),术后12、24 h试验组患者IL-8显著低于对照组(P<0.05)。两组均无严重不良反应发生,不良反应发生率无显著差异(P>0.05)。结论帕瑞昔布超前镇痛对胃癌根治术患者有良好的镇痛效果,可降低炎症因子、应激反应激素水平。
AIM To investigate effects of preemptive analgesia with parecoxib on inflammatory factors and stress response in patients undergoing radical resection for gastric cancer. METHODS Forty patients were randomly allocated into trial group and control group （20 in each）, and received the same anaethesia. Both group received patient controlled analgesia （PCA） with morphine （1 mg mL-1） and the PCA pump began at the end of the operation. Patients in the trial group received intravenous parecoxib 40 mg after anesthesia induction, while other patients in the control group received intravenous parecoxib 40 mg at the end of the operation. Both group received intravenous parecoxib 40 mg at 12, 24 and 36 h after the operation. The following indexes were recorded after the operation： visual analogue score （VAS）, effective delivery, and drug dose. Venous blood samples were taken before anesthesia induction, at the end of operation, at 12 h and 24 h after operation for determination of serum interleukin - 6 （ IL- 6） , IL - 8, tumor necrosis factor - alpha （ TNF - a） , cortisol and angiotensin 11 （AT 11 ） concentrations. RESULTS The VAS of quiet and cough in the trial group was significantly lower than that in the control group at 6 h after PCA pump used （P 〈 0.05）. Effective delivery and drug dose in the trial group were significantly lower than those in the control group after PCA pump used （P 〈 0.05）. Compared with those in the control group, serum IL-6, TNF-a, cortisol and AT l] concentrations were significantly lower from the end of operation to 24 h after operation in the trial group, and serum IL- 8 concentration was significantly lower at 12 h and 24 h after operation in the trial group. There was no significant difference in incidence rate of adverse drug reactions between two groups （P 〉 0.05）. CONCLUSION Parecoxib can relief pain in patients undergoing radical resection for gastric cancer efficiently, decrease inflammatory factors levels, and control stress response.
出处
《中国新药与临床杂志》
CAS
CSCD
北大核心
2013年第5期405-408,共4页
Chinese Journal of New Drugs and Clinical Remedies
关键词
帕瑞昔布
镇痛
应激
炎症反应
超前镇痛
parecoxib
analgesia
stress
inflammatory response
preemptive analgesia
