CAJ | 학술논문

目的：探讨术前应用帕瑞昔布钠对行瑞芬太尼快通道麻醉的腹腔镜胆囊切除术（ LC ）患者的影响。方法将120例行腹腔镜胆囊手术患者采用随机数字表法分为两组，各60例。两组术中麻醉均采用丙泊酚与瑞芬太尼，观察组术前20 min静脉注射帕昔布钠40 mg＋0．9％氯化钠注射液2 mL，对照组仅静脉注射等量0．9％氯化钠注射液。比较两组术后心率、动脉压、镇痛评分、躁动评分等指标。结果拔管后5、15、30 min观察组心率为（75．7±4．8）次/min、（79．3±6．2）次/min、（74．2±5．2）次/min，平均动脉压为（103．5±11．3） mmHg、（104．7±12．6） mmHg、（108．4±12．7） mmHg，均低于对照组的（85．2±3．8）次/min、（88．2±5．9）次/min、（86．1±6．2）次/min、（132．3±16．3）mmHg、（135．2±14．6）mmHg、（133．6±11．8）mmHg（t＝4.722、4．357、4．236、4．732、4．367、4．063，均P＜0．05）。观察组拔管后疼痛、躁动评分为（2．5±0．9）分、（1．4±0．8）分，均低于对照组的（4．2±1．2）分、（3．2±1．2）分（t＝4．232、5．234，均P＜0．05）。结论对于LC患者，术前应用帕瑞昔布钠有助于改善麻醉清醒期血流动力学，减轻疼痛及躁动。
목적：탐토술전응용파서석포납대행서분태니쾌통도마취적복강경담낭절제술（ LC ）환자적영향。방법장120례행복강경담낭수술환자채용수궤수자표법분위량조，각60례。량조술중마취균채용병박분여서분태니，관찰조술전20 min정맥주사파석포납40 mg＋0．9％록화납주사액2 mL，대조조부정맥주사등량0．9％록화납주사액。비교량조술후심솔、동맥압、진통평분、조동평분등지표。결과발관후5、15、30 min관찰조심솔위（75．7±4．8）차/min、（79．3±6．2）차/min、（74．2±5．2）차/min，평균동맥압위（103．5±11．3） mmHg、（104．7±12．6） mmHg、（108．4±12．7） mmHg，균저우대조조적（85．2±3．8）차/min、（88．2±5．9）차/min、（86．1±6．2）차/min、（132．3±16．3）mmHg、（135．2±14．6）mmHg、（133．6±11．8）mmHg（t＝4.722、4．357、4．236、4．732、4．367、4．063，균P＜0．05）。관찰조발관후동통、조동평분위（2．5±0．9）분、（1．4±0．8）분，균저우대조조적（4．2±1．2）분、（3．2±1．2）분（t＝4．232、5．234，균P＜0．05）。결론대우LC환자，술전응용파서석포납유조우개선마취청성기혈류동역학，감경동통급조동。
Objective To observe the effects of parecoxib sodium on laparoscopic cholecystectomy ( LC ) patients after remifentanil fast track anesthesia.Methods 120 patients underwent general anesthesia for laparoscopic cholecystectomy were divided into two groups using random number table,60 cases in each group.The observation group was injected parecoxib sodium 40mg+saline solution 5 mL,while the control group was injected only saline so-lution 5mL prior to induction of anesthesia.The heart rate,mean arterial pressure,awaked time,pain score,agitation score and adverse reaction were compared.Results 5, 15, 30min after extubation, heart rate were ( 75.7 ± 4.8)times/min,(79.3 ±6.2)times/min,(74.2 ±5.2)times/min in the observation group and (85.2 ±3.8)times/min, (88.2 ±5.9)times/min,(86.1 ±6.2)times/min in the control group,and the mean arterial pressure were (103.5 ± 11.3)mmHg,(104.7 ±12.6)mmHg,(108.4 ±12.7)mmHg in the observation group and (132.3 ±16.3)mmHg, (135.2 ±14.6) mmHg,(133.6 ±11.8) mmHg in the control group,there were statistifically significant differences (t=4.722,4.357,4.236,4.732,4.367,4.063,all P <0.05).The pain score,agitation score were (2.5 ± 0.9)points,(1.4 ±0.8) points in the observation group,which were lower than (4.2 ±1.2) points,(3.2 ± 1.2)points in the control group(t =4.232,5.234,all P<0.05).Conclusion Parecoxib sodium can reduce the fast-track anesthesia agitation and pain,improve hemodynamics and stress response in LC patients.