塞来昔布在手部手术围手术期的疗效评估

目的研究观察塞来昔布在手部手术围手术期的疗效及安全性。方法60例手部手术患者，随机分为两组：实验组（塞来昔布组）（n=30）在术前1小时口服塞来昔布400mg，术后当天口服200mg，手术后第1～5天，每次口服200mg，每日2次；对照组（n=30）给予安慰剂，两组术后均不限制使用患者自控镇痛（PCA）、肌注或口服阿片类药物。分别记录两组患者的术后视觉模拟（VAS）评分、阿片类药物的用量及术后不良反应的发生率。结果实验组在术后第1～3天的VAS评分低于对照组，差异有统计学意义（P〈0．05）；术后当天和第4，5天实验组和对照组的VAS评分差异无显著性（P〉0．05）。在术后当天至术后第5天内实验组使用阿片类药物的次数少于对照组（P〈0．05）。实验组和对照组在不良反应的发生率上比较。差异无显著性（P〉0．05）。结论在手部手术围手术期使用塞来昔布的多模式镇痛方式对患者有良好的镇痛效果．可以减少术后阿片类药物的使用，并且不增加术后不良反应的发生率。

Efficacy of celecoxib in the treatment of peri-operative pain of hand surgery

Objective To evaluate the clinical effects of celecoxib in the treatment of peri-operative pain of hand surgery. Methods Sixty patients undergoing hand surgery were randomly divided into 2 groups. The observation group （n=30）,group oral administration with celecoxib 400mg lh before surgery,200mg in the same day after surgery and 200mg twice a day during five days after surgery.Cases in control group, administration with placebo.All the two groups did not restrict the requirements of intravenous analgesic pump, injected or oral opioids after surgery.After surgery, pain intensity was measured with visual analog scale （VAS）, and opium analgesic requirements, and the adverse reaction were observed. Results In the 1 D to 3D after surgery, the VAS pain scores of celecoxib group were lower than those of control group significantly （P〈0.05）.However, in the operate day, the fourth day, and the fifth day after surgery, there were no significant diferences between the two groups in the VAS pain scores （P〉0.05）.From the operate day to the fifth day after surgery, the frequency of pethidine administration in the celecoxib group was lower than that in the control group （P〈0.05）.Between the two groups, there was no significant diference about the adverse reaction （P〉0.05）. Conclusion Peri-operative celecoxib oral administration can enhance the analgesic effect, reduce the opioids requirements and the same rate of adverse reaction.