【作者】 周妮娜； 张英； 刘庆；

【机构】 自贡市第一人民医院麻醉科； 四川医科大学附属中医院麻醉科；

【摘要】 目的观察帕瑞昔布钠超前镇痛在腹腔镜胆囊切除术中的效果和安全性。方法选择择期行腹腔镜胆囊切除术患者180例,随机均分为三组:P₁组（帕瑞昔布钠40mg组）、P₂组（帕瑞昔布钠20mg组）及C组（等体积0.9%注射用生理盐水组）。于麻醉诱导前20min对各组患者静脉注射相应药物,记录患者入手术室后5min（t₁）、插管时刻（t₂）、腹压上升至14mmHg（t₃）、拔管时刻（t₄）、拔管后5min（t₅）患者血压和心率;记录t₄、t₅时点患者镇静评分（RS）;记录术后1h、2h、6h、8h、12h、24h的VAS评分。结果（1）在t₂、t₃、t₄时间点P₁、P₂组的血压和心率均明显低于C组（P<0.05）;（2）P₁、P₂组RS评分明显高于C组（P<0.05）;（3）P₁、P₂组各时点VAS评分明显低于C组（P<0.05）。结论对腹腔镜胆囊切除术的患者术前静脉注射帕瑞昔布钠20mg可维持围术期血流动力学稳定,减少全麻苏醒期的躁动,并缓解术后疼痛。更多还原

【Abstract】 Objective To observe the effect and safety of preemptive analgesia with parecoxib sodium in laparoscopic cholecystectomy surgery.Methods 180 patients who underwent the laparoscopic cholecystectomy surgery were randomly divided into three groups:P₁ group（parecoxibsodium40mg）,P₂ group（parecoxibsodium 20mg） and control group.60 cases in each group.Patients were given the prescribed medication through intravenous injection before anesthesia induction,the interval was 20 minutes.Record patient’s blood pressure and heart rate after Sminutes when he went into the operating room（t₁）.the intubation time（t₂）,the time when the intra—abdominal pressure was up to 14mmHg（t₃）,the extubation time（t₄） and 5minutes after extubation（t₅）;Recorded the sedation score（RS） in t₄ and t₅;And after operation,the pain of incision was assessed by VAS scores at lh,2h,6h,8h,12 h,24h respectively.Results（l）The blood pressure and heart rate in P₁ group and P₂ group was lower than those in control group at t₂,t₃ and t₄（P<0.05）.（2） RS scores in P₁ group and P2 group was higher than those in control group at t₄ and t₅（P<0.05）.（3） The VAS scores of patients at all the times were lower than those in control group（P<0.05）.Conclusion preemptive analgesia with parecoxibsodium 20 mg I.V.can maintain hemodynamic stabilityduring perioperative period,reduce the restless during anesthesia recovery period and alleviate the postoperative pain in laparoscopic cholecystectomy surgery.更多还原