帕瑞昔布钠用于腹部肿瘤术后的镇痛效果

目的：观察帕瑞昔布钠对全麻腹部肿瘤术后的镇痛效果.方法：行全麻腹部肿瘤手术45例,随机平均分为3组,Ⅰ组在手术开始前30 min静脉注射帕瑞昔布40 mg,Ⅱ组在手术结束前30 min静脉注射帕瑞昔布40 mg,Ⅲ组为对照组不给予帕瑞昔布镇痛,3组病人手术结束前45 min均给予负荷量地佐辛0.05 mg/kg,术后均予地佐辛自控静脉镇痛（patient-controlled intravenous analgesia,PCIA）持续镇痛48 h,PCIA配方中地佐辛剂量为0.75 mg/kg;观察3组患者术后0.25 h、2h、4h、8h及24h的视觉模拟评分（visual analoguescale,VAS）,0.25h的Remedy镇静评分,术后PCIA总使用次数,观察术后48 h内恶心、呕吐、尿潴留、出血、皮肤瘙痒、发热等不良反应.结果：术后0.25 h、2h,Ⅰ组VAS评分显著高于Ⅱ组,差异有统计学意义（P＜0.05）;术后24h内各时点,Ⅲ组的VAS评分显著高于Ⅰ组和Ⅱ组,差异有统计学意义（P＜0.05）;术后0.25 h,Ⅰ组和Ⅱ组的Remesay镇静评分显著高于Ⅲ组;术后48 hⅢ组的PCIA使用次数显著高于Ⅰ组和Ⅱ组;Ⅲ组患者术后恶心、呕吐、发热、尿潴留的发生率明显高于Ⅰ组和Ⅱ组,差异有统计学意义（P＜0.05）.结论：帕瑞昔布钠用于全麻腹部肿瘤手术具有确切的术后镇痛效果,可显著减少地佐辛PCIA的按压次数,降低不良反应发生率.

Analgesic Effects of Parecoxib after Abdominal Cancer Operation

Objective： To study the analgesic effects of parecoxib in patients after abdominal cancer surgery with general anesthesia. Methods： Forty-five patients accepting abdominal cancer operation with general anesthesia were randomly divided into three groups （n = 15）. All the patients in group I were given 40 mg parecoxib by intravenous injection in 30 min before the surgery, patients in group H received 40 mg parecoxib in 30 min before the end of the surgery ; group m was the control group. E- very patient received a loading dose of 0.05 mg/kg dezocine in 45 min before the end of the surgery, and patient-controlled intravenous analgesia （PCIA） with 0.75 mg/kg dezocine was carried out after the operation. The visual analog scale （VAS） scores in 0.25, 2, 4, 8 and 24 h after operation and Remesay scores were recorded in 0.25 h after operation. The number of using times of PCIA and ad- verse reactions, such as nausea, vomiting, urinary retention, bleeding, skin itching, fever and so on in 48h after operation were recorded. Results： VAS was significantly higher in group Ⅱ than that in group I （P 〈 0.05 ） in 0.25 h and 2 h after surgery ; In 0.25,2, 4, 8 and 24 h, VAS was significant- ly higher in group Ⅲ than that in group Ⅰ and group Ⅱ （P 〈 0.05 ）. Remesay score was significantly higher in group Ⅰ and group Ⅱ than that in group Ⅲ （ P 〈 0.05 ） at 0.25 h and 2 h. The number of using times of PCIA was significantly higher in group Ⅲ than that in group I and group Ⅱ （P 〈 0.05 ）. The incidences of nausea, vomiting, urinary retention and fever in group Ⅲ were significantly more than those in group Ⅰ and group Ⅱ （ P 〈 0.05 ）. Conclusions： Parecoxib has exact analgesic effects after abdominal cancer surgery with general anesthesia, which can reduce the number of using times of dezocine PCIA and adverse reaction rate.