帕瑞昔布钠预防腹腔镜手术全麻苏醒期躁动的临床观察

目的观察帕瑞昔布钠预防腹腔镜手术全麻苏醒期躁动的效果。方法选择全麻下行腹腔镜手术的患者40例,年龄20-58岁,随机分为对照组与帕瑞昔布钠组,每组20例。帕瑞昔布钠组在麻醉诱导前20min静注帕瑞昔布钠40mg,对照组则在麻醉诱导前20min静注生理盐水10ml。记录手术时间、麻醉时间、拔管时间并测定拔管前两组患者的Comfort评分及苏醒期间的躁动评分,观察有无恶心呕吐、术后低氧血症、低血压、返流误吸等不良反应。结果两组患者的手术时间、麻醉时间、拔管时间、术后低氧血症、低血压、恶心呕吐发生率差异均无统计学意义（P〉0.05）。Comfort评分：镇静满意率帕瑞昔布钠组为85%,明显优于对照组的50%（P〈0.05）。躁动评分：帕瑞昔布钠组中无或轻度躁动的比率为90%,明显优于对照组的45%（P〈0.05）。结论腹腔镜手术麻醉诱导前20min静注帕瑞昔布钠40mg可获得苏醒期良好的镇静效果,减少拔管期的躁动,且不增加拔管时间、术后低氧血症、恶心呕吐、返流误吸、低血压等不良反应发生率。

Clinical efficacy of parecoxib in the prevention of restlessness during anesthesia emergence in laparoscopic operation

Objective To evaluate the preventive effect of parecoxib sodium on restlessness during emergence from general anesthesia in laparoscopic operation.Methods 40 patients aged 20 to 58 years old undergoing selective laparoscopic operation were randomly divided into two groups with 20 cases each. Patients in experimental group received parecoxib sodium 40mg,and patients in control group received the same volume normal saline. Both groups were intravenous administered twenty minutes before the induction. The times of surgery,anesthesia and extubation were recorded. The comfort score before extubation and the degree of restlessness during the time of palinesthesia were evaluated. Adverse effects were recorded as well.Results There were no significant differences in the times of surgery,anesthesia and extubation and occurrence of postoperative hypoxemia,nausea and vomiting between the two groups. The satisfaction rate of the sedation was 85% in parecoxib sodium group,which was higher than 50% in control group（P0.05）.The rate of no or mild restlessness was 90% in parecoxib sodium group,which was higher than 45% in control group（P0.05）.Conclusion Injection of parecoxib sodium 40mg before induction produces a favorable sedation effect without prolongation of extubation during the emergence from general anesthesia in laparoscopic operation.