帕瑞昔布超前镇痛对子宫切除术中镇静及术后镇痛的影响

目的观察帕瑞昔布对子宫切除患者术中镇静及术后镇痛影响。方法子宫切除术患者60例分为两组(n=30),A组术前30分钟静注帕瑞昔布40mg,B组为空白对照组。两组均静脉持续靶控输注(TCI)丙泊酚,记录各组患者术中切皮(T1)、暴露子宫(T2)、关腹膜(T3)、缝皮(T4)时的RSS评分,记录术毕即刻(T5)、术后3小时(T6)、术后6小时(T7)、术后12小时(T8)、术后24小时(T9)的VAS评分,同时记录术中及术后局麻药使用量。结果患者术中两组各时间点RSS评分无统计学意义(P>0.05),A组患者术后各时间点VAS评分明显低于对照B组(P<0.05),A组术后局麻药使用剂量也明显比B组少(P<0.05)。结论预注帕瑞昔布能为子宫切除术提供较好的术中和术后镇痛作用,无明显镇静作用,能够减少术中及术后局麻药物使用量,且无明显恶心呕吐等不良反应。

The Effect of Preemptive Analgesia with Celecoxib on Intraoperative Sedation and Postoperative Analgesia in Hysterectomy

Objective To observe the effect of preemptive analgesia with celecoxib on intraoperative sedation and postoperative analgesia in hysterectomy.Methods 60 patients with hysterectomy were divided into group A(n = 30) and group B(n = 30).The group A received 40 mg celecoxib by intravenous injection 30 min before the operation,while group B was the control group;both groups received target controlled infusion(TCI) of propofol.The RSS scores at intraoperative incision(T1),uterine exposure(T2),close the peritoneum(T3) and suturing skin(T4),the VAS scores at the end of operation(T5);postoperative 3 h(T6),postoperative 6 h(T7) and postoperative 12 h(T8),postoperative 24 h(T9) were recorded.The used amounts of local anesthetics during and after operation were recorded.Results The RSS scores at every time point had no statistical significance between two groups(P > 0.05),while the VAS scores in group A at every time point were lower than those in group B(P <0.05).The used amount of local anesthetics after operation was lower than that in group B(P <0.05).Conclusions Preemptive analgesia with celecoxib has better intraoperative and postoperative analgesia,with no obvious sedation and adverse effects such as nausea and vomiting,which can reduce the used amounts of local anesthetics during and after operation.