帕瑞昔布钠与舒芬太尼预防食道癌开胸手术全麻苏醒期躁动的比较

目的 比较手术结束前分别预注帕瑞昔布钠与舒芬太尼预防食道癌开胸手术患者全麻苏醒期躁动的效果.方法 选择全麻下行食道癌开胸手术的患者90例,ASAⅠ～Ⅱ级,年龄45～73岁,随机分为帕瑞昔布钠组（P组）、舒芬太尼组（S组）和对照组（C组）,每组30例.手术结束前30 min P组和S组分别静注帕瑞昔布钠40 mg与舒芬太尼0.2 μg/kg,C组静注生理盐水10ml.记录三组患者手术时间、呼吸恢复时间、拔管时间、苏醒室停留时间;评估患者苏醒期间的躁动分级,记录患者拔管后不同时点平均动脉压（MAP）、心率（HR）.结果 三组患者的麻醉时间差异无统计学意义（P＞0.05）.S组呼吸恢复时间、拔管时间及苏醒室停留时间均长于P组和C组（P＜0.05）.P组和S组无躁动及轻度躁动例数显著低于C组（P＜0.05）.P组和S组各时点MAP及HR显著低于C组（P＜0.05）.结论 食道癌开胸手术的患者,预注帕瑞昔布钠或舒芬太尼均可明显减少全麻苏醒期躁动发生率和维持苏醒期循环稳定,且帕瑞昔布钠不延长患者呼吸恢复时间、拔管时间及苏醒室停留时间.

Comparison between parecoxib and sufentanil in the prevention of emergence agitation in thoracic surgery

Objective To compare the preventive effect ofparecoxib sodium or sufentanil in the prevention of emergence agitation in thoracic surgery.Methods Ninety patients of ASA grade Ⅰ～Ⅱ,aged 45 to 73 years old in thoracic surgery of esophageal cancer by general anesthesia,were divided randomly into three groups,with 30 cases each.30 min before operation finished,group parecoxib （group P） was injected parecoxib sodium 40 mg,group sufentanil （group S） was injected sufentanyl 0.2 μg/kg,and the control group （group C） was injected normal saline 10 ml.The times of anesthesia,restore breathing,extubation and recovery room staying were recorded.The grade of emergence agitation was evaluated.MAP,HR after extubation of the three groups were recorded.Results There were no significant differences in the times of anesthesia between the three groups （P〉0.05）.The times of restore breathing,extubation and recovery room staying of group S was significantly longer than the other two groups （P〈0.05）.The number of no or mild restlessness of group C was significantly more than group P and group S （P〈0.05）.The MAP and the HR of group P and group S were significantly lower than group C （P〈0.05）.Conclusion Injection ofparecoxib sodium or sufentanyl before operation finished can reduce the emergence agitation effectively.Parecoxib sodium does not prolong the patients breathing recovery time,extubation time and recovery room staying.