帕瑞昔布钠和氟比洛芬酯用于小儿扁桃体和腺样体切除术的比较

目的观察帕瑞昔布钠和氟比洛芬酯在小儿扁桃体和腺样体切除手术术后的镇痛效果及副作用的发生情况。方法选择全麻下行扁桃体和腺样体摘除术的患儿60例，年龄5岁～8岁，按随机数字表法均分为3组（每组20例）：A组（帕瑞昔布钠组）、B组（氟比洛芬酯组）和c组（生理盐水对照组）。A组和B组于麻醉插管后手术开始前15min分别静脉注射帕瑞昔布钠1mg／kg和氟比洛芬酯1mg／kg，C组静脉注射生理盐水2ml。观察手术时间、拔管时间、苏醒期反应、恢复期疼痛评分、术中瑞芬太尼总量以及副作用。结果3组患儿手术时间、拔管时间和术中瑞芬太尼总量相比较差异无统计学意义（P〉0．05）；苏醒期躁动发生率：A组和B组患儿均为5％，C组为55％，A组和B组明显低于C组（P〈0．01）；术后各时间点的疼痛评分C组明显高于A组和B组（P〈0．01）；A组和B组均无恶心呕吐发生，C组恶心呕吐发生率为5％。结论帕瑞昔布钠和氟比洛芬酯用于小儿扁桃体和腺样体切除手术均可获得良好的镇痛效果，减少拔管期躁动的发生，且不延迟拔管时间。

A comparison of parecoxib sodium and flurbiprofen axetil in children undergoing endoscopic adenoidectomy and tonsillectomy

Objective To investigate the postoperative analgesia effect of parecoxib sodium and flurbiprofen axetil in children undergoing endoscopic adenoideetomy and tonsillectomy. Methods Sixty children, aged 5 y-8 y, scheduled for endoscopic adenoidectomy and tonsillectomy under general anesthesia were randomly divided into group A（parecoxib sodium ）, group B（flurbiprofen axetil）, group C（normal saline ）（n=20）. Parecoxib sodium 1 mg/kg and flurbiprofen axetil 1 mg/kg were administered intravenously 15 min before the start of operation, meanwhile children in group C received normal saline. The extubation time, agitation occurrences, recovery period pain scores, remifentanil dose and side effects were observed and compared. Results There was no difference between the three groups in operation time, extubation time and remifentanil dose （P〉0.05）. The emergence of postoperative agitation was 5% in group A and group B, 55% in group C, which was significantly lower in group A and group B than that in group C（P〈0.01 ） . The pain scores of group C were significantly higher than those in group A and group B（P〈0.01 ）. The emergence of nausea and vomiting was 5% in group C. Conclusions Applying of parecoxib sodium and flurbiprofen axetil in children undergoing endoscopic adenoidectomy and tonsillectomy can provide a good analgesia effect, reduce postoperative agitation, and do not postpone the extubation time.