不同选择性环氧合酶抑制剂对瑞芬太尼麻醉后痛觉过敏的影响

目的探讨不同选择性环氧合酶抑制剂对瑞芬太尼麻醉后痛觉过敏的影响。方法选择瑞芬太尼维持的全麻下行全子宫切除术的患者60例,根据麻醉诱导前15 min用药不同分为2组,A组30例给予帕瑞昔布钠40mg,B组30例给予酮咯酸氨丁三醇30 mg,观察术后15、30 min的疼痛评分和术后4、8、12、24 h的疼痛评分,病人自控镇痛(PCA)按压次数、镇痛药物消耗量。结果 A组在术后15 min疼痛评分小于B组(P<0.05);术后4 h内A组的镇痛药物消耗量和PCA按压次数均少于B组(P<0.05)。结论麻醉诱导前给予帕瑞昔布钠相比酮咯酸氨丁三醇能更有效地抑制瑞芬太尼所致的痛觉过敏。

Effect of different selective cyclooxygenase inhibitors on remifentanil-induced hyperalgesia

Objective To explore the effect of different selective cyclooxygenase inhibitors on remifentanil-induced hyperalgesia after operation.Methods A total of 60 patients received hysterectomy under general anesthesia with remifentanil were randomly divided into group A(iv.parecoxib 40 mg) and group B(iv.ketorolac tromethamine 30 mg).The visual analogue scale(VAS) of postoperative 15 min,30 min,4 h,8 h,12 h,24 h and postoperative analgesic demand were recorded.Results The VAS scores of postoperative 15 min in group A was lower than that in group B(P<0.05).The PCA press frequency and drug consumption in group A were significantly higher than those in group B(P<0.05).Conclusion Intravenous injection of parecoxib sodium before anesthesia induction can be more effectively inhibited remifentanil-induced hyperalgesia than ketorolac tromethamine.