帕瑞昔布钠用于腹腔镜下宫外孕手术全麻诱导的临床观察

目的 观察帕瑞昔布钠用于腹腔镜下宫外孕手术全麻诱导的效果.方法 选择在全麻下行腹腔镜下宫外孕手术患者60例,美国麻醉医师协会（American Society of Anesthesiologists,ASA） 1-2级.随机分为生理盐水对照组（A组）和帕瑞昔布钠观察组（B组）,每组30例.全麻诱导时,A组：生理盐水5ml,舒芬太尼0.4μg/kg;B组：帕瑞昔布钠40mg/kg,舒芬太尼0.3μg/kg.结果 同组之间,术前心率及平均动脉压与气管插管后心率及平均动脉压均差异有显著性（P＜0.05）,气管插管后心率及平均动脉压明显高于术前;两组之间,术前心率及平均动脉压均差异无显著性（P＞0.05）,气管插管后心率及平均动脉压均差异有显著性（P＜0.05）,A组心率变化及平均动脉压变化均大于B组.A、B两组相比,拔管时间差异无显著性（P＞0.05）,拔管时镇静-躁动Richmond Agitation-Sedation Scale（RASS）评分差异有显著性（P＜0.05）,A组比B组躁动更明显.结论 腹腔镜下宫外孕手术患者全麻诱导时给予帕瑞昔布钠,不仅能降低气管插管时的应激反应,还能够有效预防拔管时躁动的发生.

The clinical effect of parecoxib on general anaesthesia induction of laparoscopic operations for ectopic pregnancy

Objective To investigate the clinic effect of parecoxib in general anaesthesia induction of laparoscopic operations for ectopic pregnancy.Methods 60 patients with laparoscopic operations for ectopic pregnancy were performed general anesthesia.The ASA were 1-2 grade.The patients were randomized into saline group （Group A,n=30） and parecoxib group （Group B,n=30）.5ml saline,0.4μg/kg sulfentanyl and 40mg parecoxib,0.3μg/kg sulfentanyl were injected into group A and group B during induction of anesthesia,respectively.Results In group A or group B,the heart rate （HR） and the mean arterial blood pressure （MAP） were significantly more that after tracheal intubation than one when enter operation room （all P＜0.05）.There were no significant difference in HR and MAP when enter operation room between two groups （all P＞0.05）.The HR and MAP after tracheal intubation was significantly more in Group A than ones in Group B （all P＜0.05）.That was no significant difference in extubation time between two groups（P＞ 0.05）.The Richmond Agitation-Sedation Scale （RASS） in extubation time was significantly more in Group A than ones in Group B （P＜0.05）.Conclusion The parecoxib in general anaesthesia induction of laparoscopic operations for ectopic pregnancy can effectively decrease the stress response after tracheal intubation and it effectively decrease the agitation rate in extubation time.