帕瑞昔布钠超前镇痛对胸科手术患者麻醉恢复期的影响

目的探讨帕瑞昔布钠超前镇痛对胸科手术患者麻醉恢复期的影响。方法择期行开胸手术患者120例,分为三组各40例。A组于手术开始前30 min给予帕瑞昔布钠40 mg,术毕前30分钟给予2 mg/kg曲马多;B组于术毕前30分钟给予2 mg/kg曲马多及2μg/kg舒芬太尼;C组于术毕前30分钟给予2 mg/kg吗啡。三组患者术后均采用芬太尼自控静脉镇痛(PCIA)。观察患者停药后自主呼吸恢复时间(T1)、清醒时间(T2)、拔管时间(T3);患者清醒时对气管导管的耐受性;拔管时及拔管后5、10、20 min血流动力学指标及镇静躁动(Riker SAS)评分;患者术后1 h的视觉模拟评分(VAS)及术后24小时内PCIA次数。结果与B、C组比较,A组患者T1、T2、T3时间明显缩短,且血压、心率更稳定,Riscker SAS评分、VAS评分以及24小时内PCIA次数更低(P<0.05)。结论帕瑞昔布钠超前镇痛应用于胸科手术能使患者在麻醉恢复期躁动小,镇痛充分,血流动力学平稳。

Effect on convalescence of preemptive analgesia with parecoxib in patients undergoing thoracotomy

Objective To evaluate the Effect on convalescence of preemptive analgesia with Parecoxib in patients Undergoing Thoraeotomy. Methods 120 patients undergoing thoraeotomy randomly were given 2 mg/kg tramadol （ A group） ,2 mg/kg tramadol and 2ug/kg sufentanil（ B group）, or 2 mg/kg morphine （ C group） 30 minutes before the end of operation. For A group ,40 mg Pareeoxi were given 30 minutes before the beginning of operation. All patients received analgesic treatment with patient-controlled intravenous analge- sia （PCIA） with Fentanyl. The recovery time of spontaneous respiration（T, ）, awaking time（ T2 ）, extubation time （T3 ） and the tolera- bility to endotracheal tube were recorded and evaluated. The Hemodynamics change, Riker SAS and visual analogue scale （VAS） were compared among three groups. Results Compared with B group and C group, the variation of SBP and HR, Riker SAS in A group was far less（P 〈 0.05） and T1 ,T2 ,T3 in A group was significantly shorter （P 〈 0.05）. The VAS and times of PCIA was more superior in A group. Conclusion Preemptive analgesia with Parecoxib may represent a better anesthetic strategy in patients Undergoing Thoracotomy.