The effects of preemptive analgesia with parecoxib on patient-controlled intravenous analgesia after lumbar operation
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摘要: 目的：观察帕瑞昔布钠超前镇痛对腰椎手术后患者静脉自控镇痛(PCIA)效果的影响。方法：择期行腰椎减压融合内固定手术患者80例，ASAⅠ～Ⅱ级，随机均分为帕瑞昔布钠组(P组)和对照组(C组)。P组在麻醉诱导前10 min静脉注射帕瑞昔布钠40 mg，C组诱导前不注射任何药物。2组术后均采用舒芬太尼复合喷他佐辛静脉PCIA。记录术后6、12、24、36、48 h患者疼痛强度评分(VAS)和舒适度评分(BCS)，48 h内患者PCIA按压总次数和有效按压次数，舒芬太尼的累积用量以及术后镇痛期间相关不良反应的发生情况。结果：P组患者术后各观察点VAS分值均明显低于C组，BCS分值均明显高于C组(P0．01)，48 h内PCIA按压总次数和有效按压次数均显著少于C组(P0．01)，舒芬太尼的累积用量显著少于C组(P0．01)，镇痛期间相关不良反应的发生少于C组(P0．05)。结论：麻醉诱导前静脉注射帕瑞昔布钠40 mg，可增强腰椎手术后舒芬太尼复合喷他佐辛静脉PCIA的效果，减少舒芬太尼的累积用量及其不良反应。Abstract: Objective:To observe the effects of preemptive analgesia with parecoxib on patient-controlled intravenous analgesia (PCIA) after lumbar operation. Methods:Eighty cases(ASA Ⅰ-Ⅱ) with lumbar operation were randomly divided into parecoxib group(group P) and control group(group C). Parecoxib sodium 40 mg was injected into the patients in group P before 10 min of anesthesia induction, patients in group C were not injected any drugs. All patients were used PCIA by pentazocine combined with sufentanil after surgery. Visual analogous scale(VAS) and bruggman comfort scale(BCS) scores of all patients were recorded at 6,12,24,36 and 48 hours after surgery. Total times of the PCIA press and times of effective press within 48 hours, and the cumulative doses of sufentanil consumption and the adverse reactions were also recorded. Results:The VAS scores of group P were significantly lower than that of group C,but the BCS scores were significantly higher compared with group C(P0. 01). Total times of the PCIA press and times of effective press of group P were significantly less than those of group C(P0. 01) within 48 hours,and the cumulative doses of sufentanil consumption and the adverse reactions were also less compared with group C(P0. 05). Conclusions:Parecoxib sodium 40mg injecting 10 min before anesthesia induction can improve the analgesic effects of pentazocine combined with sufentanil on PCIA after lumbar operation, and reduce the cumulative doses of sufentanil consumption and the adverse reactions.
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Keywords:
- analgesia /
- cyclooxygenase-2 /
- parecoxib /
- lumbar operation
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