帕瑞昔布钠在胸腰椎骨折手术全身麻醉中应用的临床观察

目的；探讨帕瑞昔布钠在胸腰椎骨折手术中，超前镇痛及预防苏醒期躁动的效果及其安全性。方法：40例ASAⅠ-Ⅱ级择期胸腰椎骨折手术患者，随机分为帕瑞昔布钠组（P组）和生理盐水组（N组）（n=20）。两组均采用两泊酚、舒芬太尼复合全身麻醉。术前，P组静脉注射帕瑞昔布钠2ml（40mg）。N组静脉注射生理盐水2ml。分别记录麻醉诱导前（T1）、拔除气管导管前（停药10min，T2），拨管时（T3）、拔管后10min（T4）各时间点．两组的评价动脉压（MAP）、心率（HR）、氧饱和度（SpO2）及躁动评分（Rs）、镇静评分（Rss）和舒芬太尼用量。结果：N组：T2～T4各点MAP、HR较P组显著升高，部分时点差异有显著性（P〈0．05）；P组RS评分显著低于N组，而RSS评分显著高于N组，舒芬太尼的用量少于N组。结论：帕瑞昔布钠用于胸腰椎骨折手术．可产生明显的超前镇痛作用，减少术中舒芬太尼的用照，并可预防苏醒期躁动发生。

Effects of Parecoxib Sodium in Thoracolumber Fracture Surgery under General Anesthesia

Objective： To observe the effect and safety of parecoxib sodiums in thoracolumber fracture surgery under general anesthesia. Method： 40 patients were randomly divided in to two groups： parecoxib sodiums group （P）, 2ml （40mg） parecoxib sodium were given before induction; and saline group （N）, 2ml saline were given before induction （n=20）. Recorded patients＇ MAP, HR, SpO2, as, RSS at following time points, T1 induction, T2 10 minutes before extubation, T3 extubation, T4 10minutes after extubation. Result： MAP, HR of N group at T2-T4 time points were higher than P group. RS score of P group was significantly lower than N group, while RSS score was higher than N group. The total dose of sulfentanyl was also higher in N group. Conclusion： Parecoxib sodium produces preemptive analgesic effection during thoracolumber fracture surgery evidently that reduced the dosage of sulfentanyl and prevents the agitation of recovery.