CAJ | 학술논문

目的观察预注帕瑞昔布对腹腔镜疝修补术后镇痛的效果.方法选取ASA分级Ⅰ～Ⅱ级行腹腔镜疝修补术的患者60例,采用随机数字表法分为预注组和对照组,每组30例.麻醉前预注组静脉注射帕瑞昔布40 mg,对照组静脉注射0.9%氯化钠4 ml.采用蛛网膜下隙联合硬膜外阻滞麻醉,术中静脉注射哌替啶、氟哌利多和地西泮维持镇静.观察并比较两组患者术后腹部切口疼痛视觉模拟评分(VAS)、肩背部疼痛等级、不良反应、止痛药使用及术后24 h内肛门排气情况等.结果预注组术后4、8、12、24hVAS显著低于对照组(P＜0.05).预注组肩背部疼痛发生率(13.3%,4/30)明显低于对照组(33.3%,10/30)(P＜0.05).预注组使用止痛药率(13.3%,4/30)也明显低于对照组(40.0%,12/30)(P＜0.05);两组不良反应、术后24 h内肛门排气情况比较差异无统计学意义(P＞0.05).结论预注帕瑞昔布用于腹腔镜疝修补术患者,可明显减轻术后腹部切口疼痛和肩背部疼痛,减少术后止痛药的使用,无明显不良反应.
목적 관찰예주파서석포대복강경산수보술후진통적효과.방법 선취ASA분급Ⅰ～Ⅱ급행복강경산수보술적환자60례,채용수궤수자표법분위예주조화대조조,매조30례.마취전예주조정맥주사파서석포40 mg,대조조정맥주사0.9%록화납4 ml.채용주망막하극연합경막외조체마취,술중정맥주사고체정、불고리다화지서반유지진정.관찰병비교량조환자술후복부절구동통시각모의평분(VAS)、견배부동통등급、불량반응、지통약사용급술후24 h내항문배기정황등.결과 예주조술후4、8、12、24hVAS현저저우대조조(P＜0.05).예주조견배부동통발생솔(13.3%,4/30)명현저우대조조(33.3%,10/30)(P＜0.05).예주조사용지통약솔(13.3%,4/30)야명현저우대조조(40.0%,12/30)(P＜0.05);량조불량반응、술후24 h내항문배기정황비교차이무통계학의의(P＞0.05).결론 예주파서석포용우복강경산수보술환자,가명현감경술후복부절구동통화견배부동통,감소술후지통약적사용,무명현불량반응.
Objective To investigate the effect of pretreatment with parecoxib for postoperative analgesia in patients undergoing laparoscopic hernia repair. Methods Sixty patients undergoing laparoscopic hernia repair were assigned in two groups by random digits table with 30 cases each. The patients in pretreating group received parecoxib 40 mg intravenously before anesthesia, and in control group with the same capacity of normal saline. All patients were anesthetized with combined spinal epidural blockage and tranquilized with pethidine, droperidol and diazepam. Postoperative pain of the abdomen incision was assessed by visual analogue scale (VAS) and the pain of shoulder or back was judged by a 4 grade scale. Side-effects, supplement analgesic, passage of gas by anus 24 h after surgery were observed as well. Results The abdomen incision VAS at 4,8,12,24 h after surgery in pretreating group were lower than those in control group (P ＜ 0.05). And the incidence of pain of shoulder or back was lower in pretreating group (13.3% ,4/30) than that in control group (33.3% ,10/30)(P ＜0.05). While the cases needing supplement analgesic also decreased in pretreating group (13.3% ,4/30) compared with control group (40.0%, 12/30)(P ＜ 0.05). And the side effects and passage of gas by anus 24 h after surgery had no significant difference in two groups. Conclusion Pretreatment with parecoxib in patients undergoing laparoscopic hernia repair may relieve the postoperative incision pain and the pain of shoulder or back while reducing the analgesic supplement without side effects.