帕瑞昔布超前镇痛在无痛人工流产手术中的应用

目的:观察帕瑞昔布超前镇痛对无痛人工流产手术患者术中及术后疼痛的影响。方法:需人工流产者80例采用双盲法随机分成帕瑞昔布组(Pr组)和对照组(C组)各40例,Pr组麻醉前静脉注射帕瑞昔布40mg,C组静脉注射生理盐水5ml。监测心电图(ECG)、脉搏氧饱和度(SpO2)、呼吸频率(RR)和平均动脉压(MAP),并记录麻醉开始前(T0)、意识消失时(T1)、扩宫颈时(T2)、呼之睁眼时(T3)的心率(HR)、SpO2、RR和MAP,记录麻醉诱导时间(开始注药到意识消失)、苏醒时间(手术结束到呼之睁眼)、术中丙泊酚用药总量、术中肢体活动和术后患者疼痛发生情况。术毕进行麻醉效果评级,手术结束患者清醒后5、15、30和60min时分别记录疼痛VRS口述痛觉评分。结果:C组患者麻醉苏醒时间较Pr组延长,且丙泊酚用药总量大于Pr组(P<0.05);两组患者不同时点MBP、RR、HR和SpO2比较差异无统计学意义(P>0.05);术中患者麻醉效果评级C组较Pr组低(P<0.05);患者清醒后不同时点VRS口述痛觉评分C组较Pr组高(P<0.05)。结论:帕瑞昔布作为无痛人工流产手术超前镇痛药物,可明显减少患者术中丙泊酚用量,减轻患者术后疼痛,且不增加呼吸抑制等不良反应的发生率。

Application of parecoxib preemptive analgesia in painless artificial abortion

Objective:To observe the effects of parecoxib preemptive analgesia for painless artificial abortion.Methods:Eighty patients undergoing artificial abortion procedure were randomized into parecoxib group (group Pr) and control group (group C) (n=40 each).Before anesthesia,group C and group Pr received intravenous parecoxib 40 mg and normal saline 5 ml,respectively.Observation parameters included heart rate (RR),pulsatile oxygen saturation (SpO2),respiratory rate (RR) and mean arterial pressure (MAP) instantly before anesthesia (T0),at begin of unconsciousness (T1),when cervix was dilated (T2) and at eye opening responding to name call (T3).Anesthesia induction time (time duration between anesthetic initiation and begin of unconsciousness),emergence time (time duration between surgery ending and eye opening responding to name call),total amount of propofol,profile of body movement during procedure and post-procedure pain were also recorded.Anesthesia effects were ranked and verbal rating scale (VRS) at 5,15,30 and 60 min after emergence were recorded.Results:The emergence time of group C was significantly longer than those of group Pr,and total amount of propofol of the former was apparently larger than that of the latter (P<0.05),while no any significant difference in MBP,RR,HR and SpO2 was observed between the two groups (P>0.05).As to anesthesia effects,group C ranked behind group Pr.VRS of group Pr was lower than that of group C (P<0.05) at all time points (P<0.05).Conclusion:With its preemptive analgesia effect,parecoxib reduces propofol dose for painless artificial abortion,alleviates post-procedure pain,without increasing incidence of adverse reaction such respiratory depression.