围手术期使用塞来昔布对腰椎手术患者的镇痛作用

目的:观察腰椎手术患者围手术期使用塞来昔布的镇痛效果。方法:34例腰椎手术患者分为两组,塞来昔布组19例,在手术前8h口服塞来昔布400mg,术后当天口服200mg,手术后第1～5d,口服200mg/次,每日2次;对照组15例,不服用塞来昔布,两组在手术后均不限制使用静脉止痛泵、肌注或口服阿片类药物。观察两组术后疼痛的VAS评分、阿片类药物的用量、凝血指标的变化以及呕吐情况。结果:塞来昔布组在术后第1天、第2天手术切口疼痛的VAS评分低于对照组,差异有显著性(P<0.05);术后当天、术后第3天～第5天,手术切口疼痛的VAS评分与对照组相比无显著性差异。在术后当天至术后第5天内,塞来昔布组使用哌替啶的次数少于对照组(P<0.05);出现呕吐的次数也低于对照组(P<0.05)。两组手术前后凝血功能的变化无显著性差异(P>0.05)。结论:在腰椎围手术期使用塞来昔布对患者有良好的镇痛效果,可减少术后阿片类药物的使用,减少术后呕吐反应;且不影响患者的凝血功能。

Perioperative celecoxib administration in pain management of lumbar surgery

Objective:To evaluate the effects of perioperative celecoxib administration in pain management of patients undergoing lumbar surgery.Method:Thirty-four cases with lumbar surgery were divided into two groups,nineteen cases in celecoxib group and fifteen cases in control group.Cases in celecoxib group,oral administration with celecoxib 400mg 8h before surgery,200mg in the same day after surgery and 200mg twice a day during five days after surgery.Cases in control group,administration without celecoxib.All the two groups did not restrict the requirements of intravenous analgesic pump,injected or oral opioids after surgery.After surgery,pain intensity was measured with visual analog scale(VAS),and opium analgesic requirements,the variations of coagulation parameters and the circumstances of vomit were observed.Result:In the first day and second day after surgery,the VAS pain scores of celecoxib group were lower than those of control group significantly(P<0.05).However,in the same day,the third 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>0.05).From the same day to the fifth day after surgery,the frequency of pethidine administration in the celecoxib group was lower than that in the control group(P<0.05),the frequency of vomit in the celecoxib group was lower than that in the control group(P<0.05).Between the two groups,there was no significant difference about the coagulation parameters(P>0.05).Conclusion:Perioperative celecoxib oral administration can enhance the analgesic effect,reduce the opioids requirements and vomit,and not influce the coagulation function perioperatively.