帕瑞昔布钠对导尿引起的全麻患者苏醒期躁动的影响

目的探讨帕瑞昔布钠对全麻患者苏醒期躁动的影响。方法将120例全麻手术患者随机均分为三组:A组麻醉诱导前20min静脉注射帕瑞昔布钠40mg,麻醉诱导后10min插入导尿管;B组和C组麻醉诱导前20min静脉注射生理盐水10ml;C组麻醉诱导前插入导尿管,B组麻醉诱导后10min插入导尿管。记录导尿管插入前、后的HR、BP。用Riker镇静-躁动评分(SAS)评估全麻苏醒期躁动发生情况。结果与留置导尿管前比较,C组患者置尿管后BP明显升高(14.8±3.6/9.5±3.3)kPa vs.(15.9±3.7/10.4±3.4)kPa]、HR明显增快(88.3±18.6)次/分vs.(96.0±20.7)次/分](P<0.05),而A、B组无明显改变(P>0.05)。C组全麻苏醒期SAS评(3.7±1.3)分,明显优于A组的(4.1±1.2)分和B组的(5.2±1.1)分(P<0.01);A组躁动程度明显低于B组(P<0.05)。结论全麻诱导后插入导尿管能降低BP、HR的波动,但明显增加全麻苏醒期躁动的发生;预先静脉给予帕瑞昔布钠且于麻醉诱导后导尿,既可维持循环稳定,又可有效减少全麻患者苏醒期躁动的发生。

Effect of parecoxib sodium on urethral catheterization-induced agitation during recovery from general anesthesia

Objective To investigate the effect of parecoxib sodium on urethral catheterization-induced agitation during recovery from general anesthesia.Methods A total of 120 patients undergoing general anesthesia was equally randomized into 3 groups.The patients in group A received intravenous injection of parecoxib sodium 40 mg at 20 min before anesthesia induction and the urethral catheter was inserted at 10 min after anesthesia induction.The patients in group B were given normal saline 10 ml at 20 min before induction and the urethral catheter was inserted at 10 min after induction.The patients in group C were given normal saline at 20 min before induction and the urethral catheter was inserted at 10 min before induction.The changes of HR,BP after urethral catheterization were recorded and the incidence of agitation during recovery from general anesthesia was evaluated with sedation-agitation scale(SAS).Results Compared to before,BP and HR after urethral catheteration in group C were significantly higher (14.8±3.6/9.5±3.3) kPa vs.(15.9±3.7/10.4±3.4) kPa and(88.3±18.6) beats/min vs.(96.0±20.7) beats/min](P<0.05),which were not significantly increased in groups of A and B(P>0.05).The SAS was(3.7±1.3) points in group C,which was less than(4.1±1.2) points in group A or(5.2±1.1) points in group B(P<0.01).The SAS was lower in group A than that in group B(P<0.05).Conclusion Insertion of urethral catheter after induction of general anesthesia can reduce hemodynamic fluctuations,but increase the incidence of agitation during recovery from anesthesia.The injection of parecoxib sodium before anesthesia induction and insertion of the urethral catheter after induction are effective in maintaining circulation stable and reducing agitation during recovery from general anesthesia.