帕瑞昔布钠、曲马多用于鼻内窥镜手术术后镇痛效果的观察

目的观察鼻内窥镜手术后单次静注帕瑞昔布钠、曲马多的镇痛效果。方法将择期鼻内窥镜手术患者60例随机均分成帕瑞昔布钠组与曲马多组，帕瑞昔布钠组手术结束前30min静注帕瑞昔布钠40mg，曲马多组手术结束前30min静注曲马多2mg／kg。两组患者均采用七氟醚联合舒芬太尼一丙泊酚静吸复合全麻。当患者出现恶心呕吐时立即静注恩丹西酮8mg。分别记录患者清醒后30min、1、2、4、6、12、24h的VAS评分和不良反应（恶心、呕吐、躁动等）。结果两组各时点VAS评分差异无显著性；帕瑞昔布钠组恶心呕吐病例数（2例，6．67％）显著低于曲马多组（15例，50．00％）。曲马多组眩晕3例（10％）、躁动2例（6．67％），均高于帕瑞昔布钠组（眩晕1例）。结论鼻内窥镜手术中单次静注帕瑞昔布钠镇痛效果好，不良反应发生率低于静注曲马多。

Clinical Observation on Preemptive Analgesia Effects of Parecoxib Sodium and Tramadol for Endoscopic Nasal Surgery

Objective To investigate the effect of preemptive analgesia of parecoxib sodium and tramadol in patients receiving endoscopic nasal surgery. Methods Sixty ASA I - Ⅱ patients,aged 18 - 65 yr , scheduled for elective endoscopic nasal surgical operation were randomly divided into two groups（ n = 30 each） ：parecoxih-sodium group received intravenous parecoxib-sodium 40 mg at 30 minutes before the operation completed and control group received intravenous tramadol 2 mg/kg at the same time. All patients received Sevoflurane combined with sulfentanil and propofol anesthesia. The occurrence of postoperative nausea and vomiting were intravenous injected ondansetron 8 mg immediately. The intensity of pain was measured using VAS score after the patients consciousness came back 30 rain, 1 h,2 h,4 h,6 h, 12 h and 24 h; and the adverse effects（ nausea, vomiting and mania）were recorded. Results The VAS score had no significant difference between the group of Parecoxib sodium and tramadol in the endoscopic nasal surgery. The occurrence of adverse effects （ nausea , vomiting and mania） was 50.00% ,6.67%, 10% respectively in the group of tramadol. It was significantly higher than that in the group of Pareeoxib sodium （ P 〈 0.05 ）. Conclusion Intravenous parecoxib sodium can safely, effectively offer pre- emptive analgesia in patients receiving endoscopic nasal surgery, and the occurrence of adverse effects was lower than tramadol group.