帕瑞昔布钠预防性镇痛对全麻苏醒期躁动的影响

目的: 观察帕瑞昔布钠超前镇痛对全麻患者苏醒期躁动的影响.方法: 择期全麻下手术患者60例,ASAⅠ～Ⅱ级,随机均分为对照组(C组)和帕瑞昔布钠组(P组).C组0.9%氯化钠注射液4 ml,P组在麻醉诱导前10 min静脉注射帕瑞昔布钠40 mg(用0.9%氯化钠注射液稀释为4 ml).观察2组患者自主呼吸恢复时间、拔除气管导管时间、麻醉苏醒期躁动的发生率及程度以及拔管后10 min患者的疼痛评分,并记录患者苏醒期恶心、呕吐、嗜睡以及呼吸抑制等不良反应的发生率.结果: 2组患者自主呼吸恢复时间和气管导管拔除时间差异均无统计学意义(P>0.05);P组躁动的发生率及程度均明显低于C组(P<0.01);拔管后10 min疼痛评分P组显著低于C组(P<0.01);C组患者苏醒期恶心1例,2组均无呕吐、嗜睡和呼吸抑制的发生.结论: 全麻诱导前10 min静脉注射帕瑞昔布钠40 mg,既能发挥预防性镇痛作用,又能有效预防和减少苏醒期躁动,并不延长患者自主呼吸恢复时间和拔管时间,且不良反应发生率低,可明显提高患者苏醒期的安全性.

The effect of preemptive analgesia of parecoxib sodium on preventing agitation in recovery period of general anaesthesia

Objective： To observe the effects of preemptive analgesia of parecoxib sodium on preventing agitation in recovery period of general anaesthesia. Methods： Sixty patients with ASA Ⅰ-Ⅱ scheduled with operation were randomly divided into the parecoxib sodium group（ P group） and control group（ C group）（ 30 cases each group）. Ten minutes before general anesthesinduction,the group P and group C were injected with 40 mg of parecoxib sodium（ 4 ml） and 4 ml of normal saline,respectively. The time of spontaneous breathing recovery and extubation,the incidence and degree of agitation in anesthesia recovery period,the pain score at 10 minutes after extubation of all patients were observed. The incidence of adverse reactions,such as nausea and vomiting in recovery period,drowsiness and respiratory depression,of all patients were recorded. Results： There were not statistically significant in the time of spontaneous breathing recovery and extubation between two groups（ P 〉0. 05）. Compared with group C,the incidence and degree of agitation and pain score at 10 minutes after extubation in group P were significantly lower（ P〈0.01）. One case with nausea in group C in recovery period was found,no vomiting,drowsiness and respiratory depression were found in two groups. Conclusions： The injection with 40 mg of parecoxib sodium 10 minutes before general anesthesia induction can play analgesic effect,reduce and prevent the agitation in anesthesia recovery period and significantly improve the safety of the recovery period,but it doesn＇ t prolong the time of spontaneous breathing recovery and extubation.