单次帕瑞昔布钠对曲马多术后镇痛效果的影响

目的观察术毕单次应用帕瑞昔布钠是否改善曲马多的镇痛效果。方法 60例择期腹部手术患者随机均分为两组:T组术毕实施曲马多患者自控静脉镇痛(PCIA);TP组PCIA前静脉注射帕瑞昔布钠40mg。PCIA:术毕前30min静脉注射曲马多1.5mg/kg和昂丹司琼8mg;术毕接镇痛泵(曲马多15mg/kg、昂丹司琼16mg稀释至100ml)。记录术后4、24及48h的VAS疼痛评分、Ramsay镇静评分、舒适度评分(BCS)、追加镇痛药人数、镇痛泵按压次数和不良反应发生情况。结果与T组相比,TP组术后24h的VAS、术后4h追加镇痛药人数,术后4、24和48h镇痛泵按压次数均明显减少(P<0.05)。两组均无严重不良反应。结论曲马多PCIA前加用帕瑞昔布钠可改善曲马多术后镇痛效果。

Effects of parecoxib sodium on the analgesic efficacy during patient controlled intravenous analgesia with tramadol

Objective To investigate if a single dose of parecoxib sodium improves analgesic effect of tramadol.Methods Sixty surgical patients were equally randomized into two groups.The patients in group T were given patient-controlled intravenous analgesia(PCIA) with tramadol(intravenous injection of tramadol 15 mg/kg and ondansetron 16 mg) and those in group TP were given additional parecoxib sodium 40 mg at 30 min before the end of surgery.PCIA was performed with tramadol 1.5 mg/kg and ondansetron 8 mg in 100 ml normal saline.VAS score,Ramsay sedative score,Bruggrmann comfort scale(BCS) score were evaluated at 4,24 and 48 h after the surgery.the number of the patients receiving rescue analgesic medication,the number of PCA button pressing and adverse effects related to analgesia were recorded.Relusts Compared with group T,the patients in group TP had significantly lower VAS scores,less numbers of PCA button pressing and rescue medication during PCIA.The incidence of adverse events was similar between two groups.ConclusionCompared with tramadol hydrochloride alone,parecoxib sodium 40 mg given before PCIA can effectively enhance analgesic effects of PCIA with tramadol.