塞来昔布在手部手术围手术期的镇痛疗效

目的:评价塞来昔布在手部手术围手术期的镇痛疗效.方法:将2009年1月至12月收治的60例手部手术患者随机分为观察组和对照组各30例,观察组在术前1h口服塞来昔布400 mg,术后当天口服200mg,术后1～5天,每日两次,每次口服200 mg;对照组予安慰剂,两组术后均不限制使用患者自控镇痛、肌注或口服阿片类药物.比较两组患者的术后视觉模拟( VAS)评分、阿片类药物的用量及术后不良反应的发生率.结果:观察组在术后1～3天的VAS评分明显低于对照组(P＜0.05),术后当天和第四、五天两组的VAS评分无明显差异(P＞0.05)；在术后当天至术后第五天内观察组使用阿片类药物的次数明显少于对照组(P＜0.05)；两组不良反应的发生率无显著性差异(P＞0.05).结论:在手部手术围手术期使用塞来昔布可提高镇痛效果,减少术后阿片类药物的使用,而不增加术后不良反应的发生率.

Efficacy of Celecoxib in Treatment of Perioperative Pain of Hand Surgery

Objective： To evaluate the analgesic effects of perioperative celecoxib administration of perioperative pain of hand surgery. Methods：60 cases undergoing hand surgery were randomly divided into observation group and control group, and each group was 30 cases. The observation group was oral administration with celecoxib 400 mg 1 h before surgery,200 mg in the same day and 200 mg twice a day during five days after surgery.Cases in control group were administration with placebo.All the two groups did not restrict the requirements of intravenous analgesic pump, injected or oral opioids after surgery. The pain intensity was measured with visual analog scale （VAS）, opium analgesic requirements and the adverse reaction were compared between the two groups after surgery. Results： In 1-3 day after surgery, the VAS pain scores in the observation group were lower than those in the control group significantly （P〈O.OS）.However, in the same day, the fourth day and the fifth day after surgery, there were no significant differences between the two groups in the VAS pain scores （P〉O.05）. From the same day to the fifth day after surgery,the frequency of opioids administration in the observation group was lower than that in the control group （P〈0.05）. Between the two groups,there was no significant difference about the adverse reaction （P〉0.05）. Conclusion： Perioperative celecoxib oral administration can enhance the analgesic effect ,reduce the opioids requirements and the same rate of adverse reaction.