超前镇痛在鼻内镜手术术中及术后的镇痛效果研究

目的：评价帕瑞昔布钠和喷他佐辛超前镇痛应用于鼻内镜手术术中及术后的镇痛效应,为临床合理应用超前镇痛提供参考。方法：以120例局部麻醉鼻内镜下行鼻中隔矫正加鼻甲射频消融术的患者为研究对象,随机分为帕瑞昔布钠组（A组）、喷他佐辛组（B组）及对照组（C组）,每组40例;分别于术前30min单次肌内注射帕瑞昔布钠40mg、喷他佐辛30mg及相同容积生理盐水。采用视觉模拟评分（VAS）评估3组患者术中和术后3、24、48h的疼痛情况,同时记录术后追加镇痛药使用情况及药物相关不良反应的发生情况。结果：与C组相比,A组及B组在术中和术后3、24、及48h的VAS均显著降低（P〈0.05）。与C组相比,A组与B组术后追加镇痛药使用率减少（P〈0.05）。结论：局部麻醉鼻内镜下鼻中隔矫正加鼻甲射频消融术前给予帕瑞昔布钠和喷他佐辛均可收到良好的超前镇痛效果,安全性较高,值得在临床工作中推广应用。

Study on the preemptive analgesia effects of both the parecoxib sodium and the pentazocine in patients undergoing nasal endoscopic surgery

Objective：To evaluate the preemptive analgesia effects of both the parecoxib sodium and the pen- tazocine in patients undergoing nasal endoscopic surgery. Method： In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups （n：40） ： group A received parecoxib 40 mg by muscle injection 30 rain before the operation; group B received pentazocine 30 mg; group C received an equal volume of saline. The preemptive analgesia effect was evaluated with VAS scores which recorded at different time points. The proportion of participants using rescue analgesia after the operation were recorded as additional meas- ures of preemptive analgesia. Resolt：Intra-operative as well as the postoperative pain scores were less in the group A and group B than in the control group. Fewer participants required rescue medication after operation with parecoxib as well as pentazocine than placebo. However there were no difference in the preemptive effects between the group A and group B. Conclusion.. Administration of both the parecoxib and pentazocine before the nasal endoscopic surgery can provide preemptive analgesia without serious adverse side effects that deserves popularization in the clinic.