布地奈德联合帕瑞昔布钠对胸科手术患者术后咽痛的影响?

【目的】探讨雾化吸入布地奈德联合帕瑞昔布钠静脉注射对支气管插管胸科手术患者术后咽喉痛(postoperative sore throat,POST)的影响。【方法】拟行胸科双腔支气管插管患者160例,年龄18~64岁,随机分为四组,每组40例患者,对照组(C组)不进行干预,B组患者麻醉恢复室拔除支气管导管后30 min雾化吸入布地奈德1 mg,P组患者手术结束前30 min静脉给予帕瑞昔布钠40 mg,BP 组患者手术结束前30 min静脉给予帕瑞昔布钠40 mg,同时患者麻醉恢复室拔除支气管导管后30 min雾化吸入布地奈德1mg。记录拔管后1 h、6 h、24 h的咽痛、声嘶发生率及咽痛视觉模拟评分(Visual Analogue Score,VAS)。【结果】四组患者年龄、性别比例、身高、体质量、手术时间、支气管保留时间差异无统计学意义(P >0.05)。B组、P 组和 BP 组拔管后各时间点咽痛发生率及咽痛 VAS评分明显低于C组(P <0.05),且BP组明显低于 B组和 P 组(P <0.05),各组未见与药物应用相关的明显不良反应。【结论】布地奈德早期雾化吸入联合帕瑞昔布钠静脉注射能够有效降低双腔支气管插管患者POST的发生率并减轻其严重程度,同时提高患者对麻醉复苏期的护理满意度。

Effect of Budesonide and Parecoxib Sodium Treatment on Relieving Postoperative Sore Throat after Tracheal Intubation of Thoracic Surgery Patients

Obj ective]To evaluate the effects of inhaling budesonide after extubation and parecoxib inj ection on the prevention and treatment of postoperative sore throat (POST)after tracheal intubation with a double-lumen endobronchial tube in thoracic surgery patients.[Methods]One hundred and sixty patients aged 18~64 scheduled for elective thoracic surgery under general anesthesia were randomly divided into four groups equally with 40 pa-tients each group.Patients in group C received no inhalation treatment.Patients in group B inhaled 1 mg budesonide 30 minutes after extubation,patients in group P received a 40 mg parecoxib injection of sodium 30 minutes before postoperation,and patients in group BP inhaled 1mg budesonide and received a 40 mg parecoxib injection of sodi-um with a double_lumen endobronchial tube.The incidence and VAS score of POST at 1h,6h and 24h in the post-operative period after tracheal extubation were assessed.[Results]There was no statistical significance of patients 'age,sex ratio,height,weight,time of operation,or intubation (P >0.05).The incidence and VAS scores of POST were significantly lower in group B,group P,and group BP than those of group C (P <0.05),and lower in group BP than in group B and group P (P <0.05)after removal of endotracheal tube on a three point scale.No adverse reactions of inhalation of atomization and parecoxib sodium inj ection occured in any group.[Conclusion]The combination of budesonide and parecoxib sodium is safe and can reduce the incidence and VAS score of POST after tracheal intubation with a double-lumen endobronchial tube.