预先静脉注射帕瑞昔布钠对术后芬太尼患者自控静脉镇痛的影响

目的 探讨预先静脉注射帕瑞昔布钠对术后患者白控静脉镇痛(PCIA)的影响.方法 60例择期下肢骨折内固定取出术患者随机均分成三组,I组于切皮前30 min静注帕瑞昔布钠40 mg,II组缝皮结束时静注帕瑞昔布钠40 mg;Ⅲ组不用帕瑞昔布钠.三组术毕均用芬太尼PCIA.记录术后8、24、48 h的VAS评分及术后24 h内芬太尼用量及其不良反应.结果 三组术后镇痛效果均满意.术后8、24 h VAS评分:I组明显小于Ⅱ组(P<0.05);III组明显大于Ⅱ组(P<0.05).术后24 h内芬太尼用量I组(0.30±0.07)mg、Ⅱ组(0.34±0.09)mg,明显少于Ⅲ组的(0.43±0.08)mg(P<0.05).三组间不良反应无明显差异.结论 术前预先静脉内注射帕瑞昔布钠在一定程度上能增强术后镇痛效果、减少术后镇痛芬太尼用量.

Influence of preoperative injection of parecoxib sodium on PCIA with fentanyl in man

Objective To study the effect of patient-controlled intravenous analgesia (PCIA) with fentanyl. Methods Sixty patients undergoing the removal of internal fixation of the lower extremity were randomized to three groups with 20 cases each. The patients in group I were injected intravenously parecoxib sodium 40 mg 30 min before operation, which was given at the end of operation in group Ⅱ . The patients in group Ⅲ were not given as the controls. All patients received PICA with entanyl. The analgesic effect was observed by VAS at 8, 24, and 48 h after surgery. The fentanyl consumption and adverse responses were recorded as well. Results Analgesia was satisfectory in all cases. VAS points at 8 and 24 h after operation were significantly lower in group Ⅰ than those in group Ⅱ (P<0. 05), which were all lower than those in group Ⅲ (P<0. 05). The consumption of fentanyl of roup Ⅲ was significantly greater than that in group Ⅰ or group Ⅱ (0. 43±0. 08) mg vs. (0. 30 ± 0. 07) mg or (0. 34±0. 09) mg] (P<0. 05). There was no significant difference in adverse responses among three groups during analgesia. Conclusion Preoperative injection of parecoxib sodium may improve the outcomes of PCIA with fentanyl and reduce comsumption of fentanyl in the patients underwent removal of internal fixation.