妇科术后帕瑞昔布钠联合舒芬太尼静脉自控镇痛疗效观察

目的：观察帕瑞昔布钠复合舒芬太尼静脉自控镇痛（PCIA）用于妇科术后镇痛的疗效及安全性。方法：66例妇科手术患者随机分为观察组与对照组。两组患者均在拔管后予舒芬太尼PCIA，观察组在缝皮前和术后12h分别静注帕瑞昔布钠40mg，对照组在同一时间静注0.9%氯化钠注射液5ml。观察两组患者术后1h（T1）、2h（T2）、6h（T3）、12h（T4）、24h（T5）的镇痛评分（VAS）与镇静评分（Ramsay）。记录术后24hPCIA按压次数、有效按压次数、舒芬太尼用量、患者镇痛满意度及药品不良反应。结果：观察组患者各时间点镇痛评分及镇静评分均优于对照组（P〈0.05），24hPCIA总按压次数、有效次数、舒芬太尼用量均少于对照组（P〈0.05），镇痛满意率优于对照组（P〈0.05），药品不良反应发生率少于对照组（P〈0.05）。结论：帕瑞昔布钠复合舒芬太尼用于妇科术后PCIA可减少舒芬太尼用量，提高镇痛及镇静效果，药品不良反应少，是一种安全有效的术后镇痛方法。

Effect Observation of Gynecological Postoperative Patient Controlled Intravenous Analgesia (PCIA) of Parry Celebrex Sodium Combined with Sulfentanyl

Objective： To discuss the curative effect of gynecological postoperative patient controlled intravenous analgesia （PCIA） of parry celebrex sodium combined with sulfentanyl. Methods：Totally 66 cases with gynecological operation were randomly divided into the observation group and the control group. The patients in the two groups were both given PCIA of sulfentanyl after the tube withdrawal, and the patients in the observation group were given 40mg parry celebrex sodium respectively before skinning suture and 12 hours after the operation by intravenous injection, while the patients in the control group were given 5ml sodium chloride injection （0.9%） at the same time. The VAS and Ramsay scores of the patients at the stages of 1h （T1）, 2h （T2）, 6h （T3）, 12h （T4） and 24h （T5） after the operation were observed. The press times of PCIA, effective press times, amount of sulfentanyl, VAS satisfaction rates and adverse drug reactions （ADR） in 24 hours after the operation were recorded. Results：The VAS and Ramsay scores of the patients in the observation group at the different stages were much higher than those in the control group （P〈0.05）. The total press times of PCIA, effective press times, amount of sulfentanyl of the patients in the observation group in 24 hours after the operation were much lower than those in the control group （P〈0.05）. The VAS satisfaction rate in the observation group was much higher than that in the control group （P〈0.05）, and the ADR occurrence rate in the observation group was much lower than that in the control group （P〈0.05）. Conclusion：The application of parry celebrex sodium combined with sulfentanyl on PCIA after the operation can reduce the amount of sulfentanyl and enhance the VAS and Ramsay effect with fewer adverse drug reactions, which is a safe and effective VAS method after the operation.