帕瑞昔布对舒芬太尼复合曲马朵术后静脉镇痛效果的影响

目的 观察帕瑞昔布对舒芬太尼复合曲马朵术后静脉镇痛效果及不良反应的影响。方法全麻手术患者60例，随机分成3组，每组20例。I组术毕连接镇痛泵、II组术毕静脉注射帕瑞昔布0.8mg·kg^-1后连接镇痛泵、III组术毕静脉注射帕瑞昔布0.8mg·kg。后连接镇痛泵，术后6h时再静脉注射帕瑞昔布0.6mg·kg^-1。记录术后疼痛评分、镇静评分、PCA有效按压次数及不良反应。结果 II、III组的疼痛评分在术后各时点低于I组，III组低于II组（P＜O.05）。I组患者恶心呕吐、PCA有效按压次数高于II、III组，II组PCA有效按压次数高于III组（P＜0．05）；3组头晕发生率及镇静评分差异无统计学意义（P＞0．05）。结论舒芬太尼复合曲马朵术后静脉镇痛加用帕瑞昔布，能增强镇痛效果，术毕即刻及术后6h时两次给药法镇痛效果佳且不良反应少。

Effect of parecoxib on the postoperative intravenous analgesia with sufentanil and tramadol

Objective To evaluate the effect of parecoxib on the postoperative intravenous an- algesia with sufentanil and tramadol. Methods Sixty postoperative patients were randomly divided into three groups, 20 cases in each. Postoperative intravenous analgesia was given after the operation in group I , which followed by intravenous parecoxib 0.8 mg·kg^-1 in group Ⅱ and Ⅲ ,and parecoxib 0.6 mg·kg^-1 was intravenously injected again at 6 hours after operation in group m. VAS, sedation score, the effective PCA times and the incidences of adverse reactions were recorded postoperatively. Results VAS in group II and group III at different times after operation was lower than that in group I , and VAS in group III was lower than that in group II （P〈0.05）. Compared with group II and Ⅲ , the incidences of nausea and vomiting and the effective PCA times were low in group I ,and the effective PCA times in group II was higher than that in group Ⅲ（P〈0.05）. No significant differ- ences were found in sedation score and the incidence of dizziness among the three groups （P〉0.05）. Conclusion Addition of parecoxib to postoperative intravenous analgesia with sufentanil and tramad-ol can enhance the analgesia effects, with less adverse reactions.