【摘要】 目的观察帕瑞昔布钠用于神经外科术后镇痛和躁动的作用。方法 40例择期神经外科手术患者,随机均分为帕瑞昔布钠组(P组)和对照组(C组),关硬脑膜后分别静注帕瑞昔布钠40 mg(10 ml)或生理盐水10 ml,同时给予托烷司琼5 mg。观察血流动力学、呼吸恢复时间、睁眼时间、拔管时间、躁动发生与程度、恶心呕吐发生率,记录拔管时、拔管后5、10 min时的躁动评分(RS)及Ramsay镇静(RSS)评分;并记录术后6、12、24 h VAS、RS及RSS评分。结果注药前、注药后5、10 min两组患者MAP和HR差异无统计学意义;拔管时及拔管后5、10 min时C组MAP高于、HR快于注药前和P组(P<0.05)。拔管时及拔管后5、10 min C组RS评分明显高于、RSS评分低于P组(P<0.05)。两组患者呼吸恢复时间、睁眼时间、拔管时间、术后恶心呕吐的发生率差异均无统计学意义。术后6、12、24 h C组VAS、RS评分明显高于、RSS评分低于P组(P<0.05)。结论帕瑞昔布钠可安全用于神经外科术后镇痛,并可有效预防躁动。更多还原

【Abstract】 Objective To observe the effect and safety of parecoxib sodium on postoperative pain and agitation in neurosurgical patients.Methods Forty selective neurosurgical patients were randomly divided into two groups.They received parecoxib sodium 40 mg(group P) or normal saline 10 ml(group C) after closing of dura mater.All patients also received tropisetron 5 mg at the same time.The time to breathe,time to open eyes,time to extubation,the incidence and intensity of agitation,nausea and vomiting,and hemodynamics were recorded.RS,RSS scores during extubation,5 min and 10 min were recorded.VAS,RS and Rss sedation scores 6,12,24 h after operation were also recorded.Results There was no difference in MAP and HR 5 min and 10 min before the treatment in two groups.During extubation,5 min and 10 min later,MAP and HR in group C were higher than before treatment and in group P(P<0.05);the incidence of RS score in group C was higher than group P whereas the incidence of RSS score in group C was lower than group P(P<0.05).There were no differences in the time to breathe,time to open eyes,time to extubation,and the incidence of postoperative nausea and vomiting.At 6,12,24 h after operation VAS,RS score in group C were higher than in group P while RSS score in group C was lower than in group P(P<0.05).Conclusion Parecoxib sodium is safe for postoperative analgesia in neurosurgical patients with a protective effect on agitation.更多还原