【摘要】 目的观察帕瑞昔布钠对下肢手术后镇痛效果的影响。方法 45例ASAⅠ或Ⅱ级全麻下行下肢矫形手术的患者随机分为三组,A组全麻诱导前静注帕瑞昔布钠40mg,B组缝合伤口时静注帕瑞昔布钠40mg,C组为对照组。三组患者于缝皮时开启皮下自控镇痛(PCSA)泵(100ml溶液含芬太尼2.0mg)。记录苏醒后即刻(T1)、术后4h(T2)、24h(T3)、36h(T4)的VAS评分,记录术后4h及24h内PCSA按压次数,术后24h芬太尼用量,观察头晕、恶心呕吐发生率。结果 T1～T3时A、B组VAS评分均显著低于C组(P<0.05);T1、T2时A组VAS评分显著低于B组(P<0.05)。A和B组术后24hPCSA泵按压次数、芬太尼总量及术后恶心呕吐发生率显著低于C组(P<0.05)。结论下肢手术中使用帕瑞昔布钠具有良好的镇痛作用和超前镇痛作用。更多还原

【Abstract】 Objective To investigate the analgesic effects of parecoxib on lower limb surgery.Methods forty-five patients,ASA Ⅰor Ⅱ,undergoing lower limb surgery under general anesthesia were randomly divided into three groups:group A(40mg parecoxib before anesthesia induction ),B(40mg parecoxib on closure of the wound) and C(control group). All patients received patient-controlled subcutaneous analgesia (PCSA,containing fentanyl 2.0mg diluted to 100ml) at the end of the surgery. Visual analog score (VAS) was recorded to evaluate post-operative pain at the time of analepsia (T1),and 4 h(T2),24 h(T3) and 36 h(T4) after the surgery. PCSA button press times,total fentanyl usage and the incidence of dizziness,nausea and vomiting were also recorded. Results The VAS score at T1-T3 were significantly lower in group A and group B than those in group C (P<0.05),and the VAS score at T1,T2 were significantly lower in group A than those in group B(P<0.05). PCSA button press times and total fentanyl usage 24 hours after surgery and the incidence of post-operative nausea and vomiting were lower in group A and group B than those in group C(P<0.05)Conclusion Parecoxib can provide good analgesia on low limb surgery and it has a preemptive analgesic effect.更多还原