帕瑞昔布钠对烧伤患者全麻苏醒期寒战与躁动的影响

目的：观察帕瑞昔布钠对烧伤病人全麻苏醒期寒战和躁动的影响。方法：选择70例ASAⅡ-Ⅲ级择期行切痂植皮术患者,随机分为对照组（Con）和帕瑞昔布钠组（Par）,每组各35例,分别在植皮结束创面包扎前静脉注射帕瑞昔布钠40 mg（40 mg/2 mL）和生理盐水2 mL。记录术毕至拔管时间、苏醒期间发生寒战的例数和寒战评级、躁动评分（RS）、镇静评分（RSS）、拔管后10 min记录身体舒适度评分（BCS）。结果：对照组2级以上寒战发生率（40.0%）明显大于帕瑞昔布钠组（17.1%）,且严重寒战（3级）的比例也明显高于帕瑞昔布钠组。对照组躁动发生率为65.7%,明显高于帕瑞昔布钠组（31.4%,P〈0.05）。对照组RSS为1分病人的比率（65.7%）明显大于帕瑞昔布钠组（31.4%）,相反对照组RSS为2-3分病人的比率（28.6%）明显小于帕瑞昔布钠组（60.0%）;对照组病人BCS为0分的比率（65.7%）明显大于帕瑞昔布钠组（31.4%）,而对照组舒适度评分？1分病人的比率（34.3%）明显小于帕瑞昔布钠组（68.6%）。结论：术毕前静脉注射帕瑞昔布钠可发挥镇痛作用,预防烧伤病人全麻后苏醒期寒战、躁动,提高病人的舒适度和安全性。

Effect of Parecoxib Sodium on Chills and Restlessness during Recovery from General Anesthesia in Burned Patients

Objective： To investigate the effect of intravenous parecoxib sodium prior to the end of surgery on chills and restless during recovery from general anesthesia in burned patients.Method： Seventy patients,ASA II-III class,undergoing elective skin grafting surgery were randomly divided into two groups（n=35 each group）.The patients in control group（Con） and Parecoxib sodium group（Par） received intravenous injection of Parecoxib sodium 40 mg（40 mg/2 mL） and saline 2 mL in the end of the wound dressing respectively.The time from completion of surgery to extubation,the shivering and chills grade,restlessness score（RS）,Ramesay sedation score（RSS）,and physical comfort score（BCS） were recorded in the period of recovery from anesthesia.Result： The incidence of shivering（grade 2） in control group was significantly greater than that in Par group,and the ratio of severe chills（grade 3） was higher in control group than that in Par group.The incidence of restlessness of the control group（65.7%） was significantly higher than that of Par group（31.4%,P0.05）.The ratio of patients with RSS for 1 in control group（65.7%） was significantly greater than that in Par group（31.4%）.On the contrary,the patients with RSS for 2-3 in the control group were significantly less than that in Par group.The ratio of patients with BCS for 0 points in control group（65.7%） was significantly greater than that in Par group（31.4%） while BCS≧1 ratio of patients in control group（34.3%） was significantly is less than in Par group（68.6%）.Conclusion： Intravenous Parecoxib sodium prior to the end of surgery can play the analgesic effect,prevent chills,restlessness during post-anesthesia recovery period,and improve the patient＇s comfort and safety in burned patients.