帕瑞昔布钠用于上肢骨折超前镇痛的效果观察

目的观察帕瑞昔布钠用于上肢骨折超前镇痛的效果。方法选择60例上肢骨折患者（ASAⅠ～Ⅱ级）随机分为A组（帕瑞昔布钠组）、B组（芬太尼组）、C组（对照组）,A组帕瑞昔布钠40 mg、B组芬太尼1μg/kg分别静脉注射,C组不给予任何药物,10 min后常规行肌间沟臂丛神经阻滞。观察T0（入手术室时）、T1（麻醉后10 min）、T2（切皮时）、T3（手术30 min）患者单相动作电位（MAP）与心率（HR）,采用VAS评分评价T4（术后2 h）、T5（术后4 h）、T6（术后8 h）、T7（术后12 h）患者静息与活动时疼痛程度。结果三组患者入手术室时MAP与HR差异无统计学意义（P〉0.05）,T1～T3时A、B组的MAP与HR明显低于C组（P〈0.01）,T2、T3时A组的MAP与HR低于B组（P〈0.05或P〈0.01）,术后T4～T7A组静息时VAS评分明显低于C组（P〈0.05或P〈0.01）,T5～T7A组活动时VAS评分明显低于C组（P〈0.01）,T5～T7A组静息时VAS评分低于B组（P〈0.05）,T6、T7A组活动时VAS评分低于B组（P〈0.05）。结论帕瑞昔布钠超前镇痛给药用于上肢骨折手术可减轻术中心血管反应,缓解患者术中、术后疼痛反应,且不良反应小。

Observation of pre-emptive analgesic effects of Parecoxib Sodium in upper limb fractures

Objective To observe the pre-emptive analgesic effects of Parecoxib Sodium in upper limb fractures.Methods Sixty patients with upper limb fracture(ASA level Ⅰ-Ⅱ) were randomly divided into group A(Parecoxib Sodium group),group B(Fentanyl group) and group C(control group).Group A and group B received the intravenous injection of 40 mg of Parecoxib Sodium and 1 μg/kg of Fentanyl respectively.Group C received routine interscalene brachial plexus block 10 minutes later instead of any drug.The patients’ MAP and HR at T0(when entering the operating room),T1(10 minutes after anesthesia),T2(at skin incision) and T3(30 th minute of surgery) were observed.Patients’ degrees of pain at rest and activity at T4(2 hours after surgery),T5(4 hours after surgery) T6(8 hours after surgery) and T7(12 hours after surgery) were evaluated using VAS score.Results The three groups of patients were not significantly different in MAP and HR when entering the operating room.From T1 to T3,group A and group B were significantly lower than group C in MAP and HR(P < 0.01).At T2 and T3,group A was significantly lower than group B in MAP and HR(P < 0.05 or P < 0.01).From T4 to T7 after surgery,group A was significantly lower than group C in VAS score at rest(P < 0.05 or P < 0.01).From T5 to T7,group A was significantly lower than group C in VAS score at activity(P < 0.01).From T5 to T7 after surgery,group A was significantly lower than group B in VAS score at rest(P < 0.05).At T6 and T7,group A was significantly lower than group B in VAS score at activity(P < 0.05).Conclusion The application of parecoxib sodium pre-emptive analgesia in upper limb fracture surgery can reduce intraoperative vascular reactions and relieve patients’ intraoperative and postoperative pain response and shows few side effects.