摘要
目的观察不同剂量帕瑞昔布钠对烧伤患者疼痛、炎症因子及认知功能的影响。方法选择2021年6月至2022年6月武汉市第三医院/武汉大学附属同仁医院收治的中重度烧伤患者120例,年龄18~65岁,体重指数(BMI)18~29 kg/m^(2),男76例,女44例,美国麻醉医师学会(ASA)Ⅱ~Ⅲ级,将患者根据随机数字表法分为对照组(C组)、低剂量组(L组)、中剂量组(M组)和高剂量组(H组),每组30例。C组术前及术后静脉注射生理盐水4 mL;L、M及H组术前注射帕瑞昔布钠40 mg,术后分别注射生理盐水4 mL及帕瑞昔布钠20、40 mg。记录各组患者术后12 h内(T_(1))、术后12~<24 h(T_(2))及术后24~48 h(T_(3))自控镇痛泵(PCA)的按压次数;干预前10 min及拔管后12、24、48 h简易精神状态检查(MMSE)量表评分;干预前10 min及拔管后1、48 h患者静脉血白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、S-100β和神经元特异性烯醇化酶(NSE)水平。结果T_(1)、T_(2)时间段,H、M组PCA按压次数明显低于C组(P<0.01);拔管后24、48 h,H、M组MMSE明显高于C组(P<0.01);拔管后48 h,H、M组IL-6、TNF-α、S-100β水平明显低于C组(P<0.05),H组NSE水平明显低于C组(P<0.05)。结论帕瑞昔布钠可以减少烧伤患者疼痛评分、炎性因子,改善患者短期认知功能,术前和术后分别静脉注射40 mg帕瑞昔布钠剂量最佳。
Objective To observe the effect of different doses of parecoxib sodium on pain,inflammatory factors and cognitive function in burn patients.Methods A total of 120 moderate-severe burn patients in the Burn Department of Wuhan Third Hospital from June 2021 to June 2022,aged 18 to 65 years,with body mass index(BMI)18-29 kg/m^(2),including 76 males and 44 females,and American Society of Anesthesiologists(ASA)physical statusⅡtoⅢ,were selected and randomly divided into the control group(group C),the low-dose group(group L),the medium-dose group(group M)and the high-dose group(group H),with 30 cases in each group.Group C was intravenously injected 4 mL normal saline before and after operation.Groups L,M and H were injected with 40 mg of parecoxib sodium before surgery,and 4 mL of normal saline and 20 mg and 40 mg of parecoxib sodium after surgery,respectively.The pressing times of patient controlled analgesia(PCA)within 12 h(T_(1)),12 h to<24 h(T_(2))and 24 h to 48 h(T_(3))after operation,mini-mental state examination(MMSE)10 min before operation and 12,24 and 48 h after extubation,and the level of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),S-100βand neuron-specific enolase(NSE)10min before operation and 1 h,48 h after extubation was recorded.Results The PCA pressing times within T_(1) and T_(2) in group M and H was significantly lower than that in group C(P<0.01).MMSE at 24,48 hours after extubation in group H and M was significantly higher than that in group C(P<0.01).IL-6,TNF-α,and S-100βat 48 hours after extubation in group H and M were significantly lower than those in group C(P<0.05),and NSE at 48 hours after extubation i n group H was significantly lower than that in group C(P<0.05).Conclusion Parecoxib sodium can reduce degree of pain and inflammatory,and improve short-term cognitive function in burn patients,and the best dosage of parecoxib sodium is 40mg intravenously before and after operation,respectively.
作者
胡光俊
蒋筱杨
刘鹏
杜思雨
陈卓
HU Guangjun;JIANG Xiaoyang;LIU Peng;DU Siyu;CHEN Zhuo(Department of Anesthesiology,Wuhan Third Hospital/Tongren Hospital of Wuhan University,Wuhan,Hubei 430060,China)
出处
《重庆医学》
CAS
2023年第11期1677-1681,共5页
Chongqing medicine
基金
湖北省自然科学基金项目(2018CFC882)
湖北省卫生健康委员会科研项目(WJ2021M220)
武汉市卫生健康委科研项目(WX21D09)。
关键词
帕瑞昔布钠
烧伤
疼痛
炎性因子
认知功能
parecoxib sodium
burn
pain
inflammatory factors
cognitive function
