摘要
目的:研究麻醉手术前应用新型的环氧合酶-2(COX-2)抑制剂帕瑞昔布钠对下肢骨折患者牵引去除后的转运以及体位变动所引起的疼痛减轻程度。方法:40例ASAI～III级的下肢骨折伤后24h内的急诊患者随机分为P组和C组2组(n=20)。P组在去除牵引转运手术前静推帕瑞昔布钠40mg,而对照C组则静推生理盐水。观察两组患者转运过程中的疼痛评分(VAS1)和体位变动(仰卧位变为椎管麻醉所需侧卧位)时的疼痛评分(VAS2)。术后随访患者手术记忆。结果:40例患者均顺利在硬膜外联合腰麻下顺利完成手术。C组患者的疼痛程度(VAS1和VAS2)均强于P组(P<0.01)。每一组内VAS2疼痛强度均高于VAS1(P<0.05)。术后随访所有患者均认为体位变动时疼痛(VAS2)最强。C组患者中有8例(40%)对体位变动过程中的痛苦记忆深刻,而P组中仅有3例(15%)。结论:帕瑞昔布钠在麻醉手术前应用可以安全减轻麻醉术前的急性疼痛,尤其是实施麻醉所需体位变动时的骨折疼痛有减轻作用。
Objective:To study the preoperative analgesic effect of parecoxib sodium,a selective cyclooxygenase-2 inhibitor for patients with lower extremity fracture.Methods:40 ASA Ⅰ～Ⅲ patients with lower extremity fracture were allocated to group P and group C randomly(n=20).Before being transported to operation room,patients in group P were accepted parecoxib sodium 40mg,iv.While patients in group C accepted saline iv as placebo.Pain scores during patients transportation(VAS1) and body position change(VAS2) for intraspinal anesthesia were recorded using a visual analog scale(VAS).Results:All patients accepted operations successfully under epidural combined spinal anesthesia.The pain scores(VAS1 and VAS2) in group C were higher than that in group P(P<0.01).In each group,VAS2 was higher than VAS1(P<0.05).Postoperative visit found there 8 patients(40%) in group C had sharp memory for pain during body change for intraspinal anesthesia while that in group P was 3(15%).Conclusion:Parecoxib sodium could alleviate the acute pain before anesthesia safely,especially for the acute pain during body position change for intraspinal anesthesia.
出处
《临床医药实践》
2010年第1X期71-72,79,共3页
Proceeding of Clinical Medicine
关键词
术前镇痛
环氧合酶-2抑制剂
下肢骨折
Preoperative analgesia
Cyclooxygenase-2 Inhibitors
lower extremity fracture
