中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
6期
25-27
,共3页
王承海%李雪杰%陈正燕%朱于临%孙东秀%唐晓莉%邵伟
王承海%李雪傑%陳正燕%硃于臨%孫東秀%唐曉莉%邵偉
왕승해%리설걸%진정연%주우림%손동수%당효리%소위
非甾体抗炎药%疼痛%超前镇痛
非甾體抗炎藥%疼痛%超前鎮痛
비치체항염약%동통%초전진통
Non-steroid anti-inflammatory drugs%Pain%Preemptive analgesia
目的 观察帕瑞昔布超前镇痛对消化道肿瘤患者术后镇痛效果的影响.方法 择期行胃癌、结肠癌或直肠癌手术患者60例,ASA Ⅰ～Ⅱ级,年龄40～60岁,随机分为三组:P1组和P2组分别于切皮前30 min和手术结束前30 min静脉注射帕瑞昔布40mg,C组于切皮前30 min静脉注射生理盐水2 ml.所有患者均在全身麻醉下完成手术,术毕均予舒芬太尼行患者自控静脉镇痛(PCIA).采用VAS评分评估术后疼痛程度,Ramsay评分评估术后镇静程度；记录术后首次PCIA按压时间及总的按压次数.结果 术后6～48 h P1和P2组患者VAS评分均低于C组,组间比较差异均有统计学意义(P ＜0.05)；12 -48 h P1组VAS评分低于P2组,组间比较差异有统计学意义(P ＜0.05).术后相应时点三组Ramsay评分相当,组间比较差异均无统计学意义(P＞0.05).术后三组首次按压PCA的时间分别为(351±21)、(286±21)和(206±24) min,总的按压次数分别为(3.8±1.1)、(4.9±1.0)和(8.6±0.9)次(P＜0.05).结论 帕瑞昔布钠可安全用于消化道肿瘤患者术中超前镇痛,并可减轻术后疼痛程度,改善镇痛效果.
目的 觀察帕瑞昔佈超前鎮痛對消化道腫瘤患者術後鎮痛效果的影響.方法 擇期行胃癌、結腸癌或直腸癌手術患者60例,ASA Ⅰ～Ⅱ級,年齡40～60歲,隨機分為三組:P1組和P2組分彆于切皮前30 min和手術結束前30 min靜脈註射帕瑞昔佈40mg,C組于切皮前30 min靜脈註射生理鹽水2 ml.所有患者均在全身痳醉下完成手術,術畢均予舒芬太尼行患者自控靜脈鎮痛(PCIA).採用VAS評分評估術後疼痛程度,Ramsay評分評估術後鎮靜程度；記錄術後首次PCIA按壓時間及總的按壓次數.結果 術後6～48 h P1和P2組患者VAS評分均低于C組,組間比較差異均有統計學意義(P ＜0.05)；12 -48 h P1組VAS評分低于P2組,組間比較差異有統計學意義(P ＜0.05).術後相應時點三組Ramsay評分相噹,組間比較差異均無統計學意義(P＞0.05).術後三組首次按壓PCA的時間分彆為(351±21)、(286±21)和(206±24) min,總的按壓次數分彆為(3.8±1.1)、(4.9±1.0)和(8.6±0.9)次(P＜0.05).結論 帕瑞昔佈鈉可安全用于消化道腫瘤患者術中超前鎮痛,併可減輕術後疼痛程度,改善鎮痛效果.
목적 관찰파서석포초전진통대소화도종류환자술후진통효과적영향.방법 택기행위암、결장암혹직장암수술환자60례,ASA Ⅰ～Ⅱ급,년령40～60세,수궤분위삼조:P1조화P2조분별우절피전30 min화수술결속전30 min정맥주사파서석포40mg,C조우절피전30 min정맥주사생리염수2 ml.소유환자균재전신마취하완성수술,술필균여서분태니행환자자공정맥진통(PCIA).채용VAS평분평고술후동통정도,Ramsay평분평고술후진정정도；기록술후수차PCIA안압시간급총적안압차수.결과 술후6～48 h P1화P2조환자VAS평분균저우C조,조간비교차이균유통계학의의(P ＜0.05)；12 -48 h P1조VAS평분저우P2조,조간비교차이유통계학의의(P ＜0.05).술후상응시점삼조Ramsay평분상당,조간비교차이균무통계학의의(P＞0.05).술후삼조수차안압PCA적시간분별위(351±21)、(286±21)화(206±24) min,총적안압차수분별위(3.8±1.1)、(4.9±1.0)화(8.6±0.9)차(P＜0.05).결론 파서석포납가안전용우소화도종류환자술중초전진통,병가감경술후동통정도,개선진통효과.
Objective To observe the effect of parecoxib preemptive analgesia on postoperative pain management in patients with digestive system tumor.Methods Sixty patients (ASA Ⅰ -Ⅱ,aged 40-60 years) scheduled to undergo elective stomach,colon or rectum tumor surgery were randomized into three groups:patients in group P1 and P2 received intravenous injection of parecoxib 40 mg at 30min before skin incision and the end of operation,and patients in group C received intravenous injection of normal saline 2 ml at 30 min before skin incision.All operations were performed under general anesthesia,and received sufentanyl for patient-controlled intravenous analgesia (PCIA).Patients' pain was evaluated by visual analogue scale (VAS),and patients' sedation was evaluated by Ramsay score.Results VAS of group P1 and P2 were lower than that of group C at postoperation 6 - 48 h ( P ＜ 0.05 ),and VAS of P1 was lower than that of group P2 at postoperation 12 -48 h( P ＜0.05 ).The Ramsay score was similar at corresponding timepoints between 6 -48 h( P ＞0.05 ).The first time of PCA bolus was (351 ±21),(286 ±21 ) and (206 ±24) min,the total bolus was (3.8 ± 1.1 ),(4.9 ± 1.0) and (8.6 ± 0.9) times,and there were significant differences ( P ＜ 0.05 ).Conclusions Parecoxib could be used in digestive system tumor patients for preemptive analgesia safely,and it could relieve patient's postoperative pain and improve analgesia effect.
