塞来昔布超前镇痛在妇科腹腔镜手术患者的应用

【目的】观察塞来昔布超前镇痛对妇科腹腔镜手术患者的镇痛效果及其不良反应。【方法】将60例妇科腹腔镜手术治疗的患者随机分为观察组和对照组，观察组术前48h，24h给予塞来昔布200mg，对照组术前48h，24h给予口服安慰剂（复合维生素）。术后12h、24h、36h、48h、72h两组均予塞来昔布200mg，并用视觉模拟评分法（VAS）评价术后镇痛效果，同时调查患者的镇痛满意度（SD）与睡眠满意度（SS），记录额外镇痛药物的援助情况和不良反应。两组患者于手术结束时及术后24h各取外周血2mL检测前列腺素E2（PGE2）的浓度。【结果】观察组术后2h、4h、8h、12h的VAS评分明显低于对照组（P〈0．05）。观察组SD与SS显著高于对照组（P〈0．01），而观察组的额外镇痛药的使用和不良反应的发生都少于对照组。术后24h血清中PGE2浓度观察组也明显低于对照组（P〈0．01）。【结论】塞来昔布超前镇痛用于妇科腹腔镜手术，能有效缓解术后疼痛，改善睡眠状况，减少术后镇痛药物的使用且无明显不良反应。

Application of Preemptive Analgesia with Celecoxib in Gynecologic Laparoscopic Surgery

Objective] To study the influence of preemptive analgesia with celecoxib on the postoperative pain extent, drug aid, side effect and peripheral prostaglandin E2 in the patients undergoing gynecologic laparoscopic surgery. Methods]Sixty patients scheduled for gynecologic laparoscopic surgery were randomly allocated into celecoxib group (group C) and placebo group (group P) with 30 cases for each. Celecoxib 200mg in group C or placebo in group P was given at 24h, 48h before surgery and 12h, 24h, 36h, 48h, 72h after surgery. Pain extent was evaluated using visual analog scale VAS before and after operation. The level of peripheral PGE2 was measured with PGE EIA kit. Results] The VAS score was significantly lower in group C than that in group P (P<0.05). The SD and SS score was significantly lower in group C than that in group P (P<0.01). The concentration of peripheral PGE2 was significantly lower in group C than that in group P (P<0.01). Conclusion] Preemptive analgesia with celecoxib can decrease the postoperative pain extent, drug aid in the early postoperative period in the patients undergoing gynecologic laparoscopic surgery.