帕瑞昔布超前镇痛在吻合器痔上粘膜环切术中的应用

目的探讨帕瑞昔布超前镇痛用于吻合器痔上粘膜环切术患者的安全性和有效性。方法70例ASAⅠ～Ⅱ级择期行吻合器痔上粘膜环切术患者，随机分为帕瑞昔布组和对照组。帕瑞昔布组于麻醉前5分钟静脉注射40mg帕瑞昔布作为超前镇痛，对照组则静脉给予生理盐水5ml。分别于术后4、8、12、24小时观察并记录两组病人镇痛药使用情况和不良反应，以视觉模拟计分（VAS）评价其镇痛效果，以舒适评分标准（BCS）判定病人满意程度。结果术后镇痛药使用例数帕瑞昔布组明显少于对照组（2：7，P〈0．05）。术后4、8、12、24小时VAS评分帕瑞昔布组明显低于对照组（1．0±0．6，2．6±0．6，3．6±0．5，1．8±0．6）：（1．4±0．7，3．1±0．8，4．1±0．7，2．2±0．8），P〈0．05]，BCS评分帕瑞昔昔布组显著高于对照组（3．5±0．5，2．4±0．4，1．7±0．5，2．9±0．5）：（3．1±0．6，2．0±0．5，1．2±0．6，2．6±0．5），P〈0．05]。两组病人术后不良反应差异无监著性（P〉0.05）。结论帕瑞昔布超前镇痛用于吻合器痔上粘膜环切术患者，可明显减少术后疼痛，病人满意程度高，不良反应少，安全可靠。

Preemptive analgesia with parecoxib in procedure for prolapse and hemorrhoids

Objective To explore the efficacy and safety of preemptive analgesia with parecoxib in procedure for prolapse and hemorrhoids (PPH). Methods 70 ASA Ⅰ - Ⅱ patients scheduled for PPH were randomly assigned to receive intravenous parecoxib of 40 mg 5 min before anesthesia as preemptive analgesia (parecoxib group), or 0.9％ NS of 5 ml (control group). The adverse reactions and use of analgetics were recorded postoperatively at hours 4, 8, 12, and 24. The analgetic effect was measured with VAS and the satisfactory degree in the patients was evaluated with BCS. Results The number of patients using supplementary analgetics after the procedure was smaller in the parecoxib group than in the control group (2 vs. 7,P＜0.05＝. The VAS scale was lower in the parecoxib group than in the control group at the four time points (1.0 ± 0.6vs 1.4 ± 0.7, 2.6 ± 0.6vs3.1 ± 0.8, 3.6 ± 0.5 vs4.1 ± 0.7, and 1.8 ± 0.6 vs2.2 ± 0.8; P＜ 0.05＝, whereas the BCS scale was higher (3.5 ± 0.5 vs 3.1 ± 0.6, 2.4 ± 0.4 vs 2.0 ± 0.5, 1.7 ± 0.5 vs 1.2 ± 0.6, and 2.9 ± 0.5 vs 2.6 ± 0.5, P＜ 0.05). There was no significant difference in adverse reactions between the two groups (P＞ 0.05). Conclusions Preemptive analgesia with parecoxib in procedure for prolapse and hemorrhoids can obviously relieve postsurgical pain with higher satisfaction and fewer adverse reactions. It is safe and reliable.