帕瑞昔布钠联合舒芬太尼用于全膝关节置换术后镇痛的临床研究

目的 观察帕瑞昔布钠联合舒芬太尼在全膝关节置换术后镇痛中的应用效果.方法 60例择期全麻下行人工全膝关节置换术患者,随机分为三组：舒芬太尼2 μg/kg组（Ⅰ组）,舒芬太尼2.5 μg/kg组（Ⅱ）,舒芬太尼2 μg/kg＋帕瑞昔布钠组（Ⅲ组）.记录术后2 h（T1）、6 h（T2）、12 h（T3）、24 h（T4）、36 h（T5）和48 h（T6）患者静止和运动VAS评分、Ramsay镇静评分、PCA按压次数、舒芬太尼用量、患者满意度及不良反应.结果 与Ⅰ组比较,Ⅲ组T4～T6静止VAS评分降低,T3～T6运动VAS评分降低（P〈0.05）;与Ⅱ组比较,Ⅲ组T4～T6静止VAS评分降低,T3～T4运动VAS评分降低（P〈0.05）.T3～T6 Ⅲ组PCA按压次数少于Ⅰ组和Ⅱ组;Ⅱ组术后各时点舒芬太尼用量高于Ⅲ组（P〈0.05）.Ⅱ组恶心呕吐的发生率高于Ⅰ和Ⅲ组（P〈0.05）.Ⅲ组患者满意程度高于Ⅰ和Ⅱ组（P〈0.05）.结论 帕瑞昔布钠联合舒芬太尼用于患者膝关节置换术后镇痛,效果确切,优于单独应用舒芬太尼.

Analgesic effects of parecoxib sodium combined with sufentanil in patients undergoing total knee athroplasty

Objective To evaluate the effect of parecoxib combined with sufentanil on postoperative analgesia in patients undergoing total knee athroplasty. Methods sixty patients scheduled for elective total knee athroplasty were randondy assigned to three groups：sufentani 2 μg/kg group（ I ）, sufentanil 2.5 μg/kg（Ⅱ）and sufeutanil 2 μg/kg combined with parecoxib group（ Ⅲ ）. The visual analogue scales （VAS） at rest and when moving, Ramsay sedation scores, PCA demands, sufentanil consumption, patients＇ global evaluation rating and adverse events at 2 h （T1 ） ,6 h（ T2 ） , 12 h（ T3 ） ,24 h（T4 ） ,36 h （ T5 ） and 48 h （ T6 ） after surgery were systematically recorded. Results Compared with group I , VAS scores at rest at T4 ~ T6 and VAS scores when moving at T3 - T6 were significantly decreased in group Ⅲ （P 〈0.05）. VAS scores at rest at T4 ~ T6 and VAS scores when moving at T3 - T4 were lower in group Ⅲ than in group Ⅱ （ P 〈 0.05 ）. Group m showed significantly lower pressing of PCA than I and Ⅱ groups at T3 - T6 after surgery（ P 〈 0. 05 ） ; group Ⅱ had a higher sufentanil consumption than group m at all time points（ P 〈 0.05 ）. The incidence of nausea and vomiting in group Ⅱ was higher than group I and Ⅲ （P 〈 0.05 ）. There was a higher global evaluation rating in group Ⅱ than in group ] and Ⅱ （ P 〈 0. 05 ）. Conclusion Pareeoxib combined with sufentanil resulted in significantly better postoperative analgesic management than sufentanil alone in patients undergoing total knee athroplasty.