【摘要】 目的评价术前静脉注射帕瑞昔布钠用于甲状腺手术的临床效果。方法择期全麻下行甲状腺手术患者90例,ASAⅠ或Ⅱ级,采用随机数字表法,将其随机均分为三组:A组于切皮前20min静脉注射帕瑞昔布钠40mg(生理盐水稀释至2ml);B组于术毕时静注帕瑞昔布钠40mg;C组于切皮前20min静注等容量生理盐水。术毕均使用芬太尼自控静脉镇痛,维持VAS评分≤3分。分别于术后2、4、8、12、24和48h时行BCS舒适度评分,记录患者术后24h芬太尼用量、PCIA次数、整体满意度评分(PGESM评分)及术后不良反应的发生情况。结果与C组比较,术后2、4、8、12、24和48h时A组和术后2、4hB组BCS舒适度评分明显升高(P<0.05),A组和B组术后24h芬太尼用量、追加吗啡用量及PCIA次数明显减少,PGESM评分明显升高(P<0.05);与B组比较,术后2、4、8、12、24和48h时A组BCS舒适度评分明显升高(P<0.05);A组术后24h芬太尼用量、额外追加吗啡用量及PCIA次数明显减少,PGESM评分明显升高(P<0.05)。三组患者恶心、呕吐、嗜睡、低血压和呼吸抑制发生率差异均无统计学意义。结论术前静脉注射帕瑞昔布钠可减少甲状腺手术患者术后阿片类镇痛药物的用量,是一种安全有效的镇痛方法。更多还原

【Abstract】 Objective To evaluate the efficacy of intravenous injection of parecoxib before operation in thyroid gland surgery.Methods Ninety cases of patients scheduled for thyroid gland surgery were randomly divided into group A,group B and group C with 30cases each.Group A patients received intravenous parecoxib 40mg 20min before skin incision.Group B patients received intravenous parecoxib 40mg immediately after operation,and group C received the same volume of saline 20min before skin incision.All patients received patient-controlled intravenous analgesia(PCIA)with fentanyl after surgery.The VAS score was maintained≤3.The comfort level was evaluated with Bruggrmann comfort scale(BCS)at 2,4,8,12,24and 48hafter operation.The consumption of fentanyl within 24hafter operation,total patient pressing times and the patientsglobal evaluation of study medication(PGESM)was recorded.The adverse reactions was also recorded.Results Compared with group C,the consumption of fentanyl within 24hafter operation and the pressing times were decreased.The PGESM and BCS was increased in groups A and B(P<0.05).Compared with group B,the PGESM and BCS was increased,the consumption of fentanyl within 24hafter operation and the pressing times were decreased in group A.(P<0.05)There was no significance difference in the adverse reactions among the 3groups.Conclusion Intravenous parecoxib before operation can reduce postoperative opiate need in patients undergoing thyroid gland surgery.It is a safe and effective analgesic method.更多还原