帕瑞昔布用于腹腔镜手术七氟醚全麻苏醒期躁动及不良反应的临床观察

目的探讨帕瑞昔布对腹腔镜手术七氟醚全麻苏醒期躁动及其不良反应的效果。方法择期全麻下腹腔镜手术90例,ASAⅠ~Ⅱ级及健康成人,采用随机双盲对照方法,将患者分成三组,手术结束前30分钟分别静脉注射帕瑞昔布40mg(实验组T组),芬太尼1μg/kg(对照组F组),等体积生理盐水组(空白对照组C组)。记录患者拔管前5分钟,拔管时,拔管后5分钟的心率、平均动脉压;观察各组术后躁动发生率、清醒情况、拔管时间和术后不良反应的发生率。结果①与C组相比,T组和F组拔管后躁动发生率明显减少(p<0·05);②C组患者与T组和F组相比,拔管后5分钟心率和平均动脉压明显增高(p<0·05);③T组拔管时间和苏醒时间与C组相当,均明显少于F组(p<0·05);④C组恶心、呕吐发生率及镇痛需求明显高于T组(p<0·05)。结论健康成人静脉注射40mg帕瑞昔布可以减少腹腔镜手术七氟醚全麻术后躁动的发生率,不明显延长拔管时间和苏醒时间,不增加术后不良反应发生率。

CLINICAL EXPERIENCE OF PARECOXIB AS A SUPPRESSANT OF AGITATION AFTER LAPAROSCOPIC OPERATION WITH SEVOFLURANE GENERAL ANESTHESIA AND OBSERVING THE UNTOWARD EFFECTS

Objective To investigate the effects of the parecoxib administration on agitation after laparoscopie operation with sevoflurane general anesthesia and observing the untoward effects. Methods A total of 90 patients aged from 18 years to 60 years in good health （ ASA physical status Ⅰ - Ⅱ ） undergoing selective laparoseopie surgery were randomly and double blindly divided into three groups. The patients were induced with midazolam, fengtanyl, vecuronium and propofol, and maintained with 2% -5% sevoflurane and oxygen. In group T, parecoxib 40 mg were administrated 30 minutes before the end of operation, and fentany 1 ug/kg in group F, and in group C was given an equal volume of NS. The heart rate （HR） ,mean arterial blood pressure （MAP） were assessed during the anesthesia. The extubation time, waking time, postoperative agitation, nausea and vomiting were observed and recorded. Results The agitation was remarkably suppressed in group T and group F than group C. And there was a significant difference in mean heart rate and mean arterial blood pressure in group C compared with group T and F. And the extubation time and waking time were almost the same in group T and group C, both shorter than that in group F. The rate of nausea and vomiting did not increase in group T. Conclusion It is safe and feasible to give pareeoxib 40mg to reduce agitation and untoward effect after laparoseopic operation with sevoflurane general anaesthesia.