标题：帕瑞昔布钠用于鼻内镜手术术后镇痛疗效评价

      作者：周冬青，周 期，陈 立，王丽云，谢 海
    (海南医学院附属医院麻醉科，海南 海口 570102)

      卷次： 2012年23卷11期

      【摘要】 目的 观察帕瑞昔布钠用于鼻内镜手术术后镇痛的镇痛效果和安全性。方法 选择ASAⅠ~
Ⅱ鼻内镜手术患者90例，随机分为帕瑞昔布钠组(A组)术毕前15 min静注帕瑞昔布钠40 mg、曲马多组(B组)术毕前
15 min静注曲马多40 mg和生理盐水组(C组)术毕前15分钟静注等量生理盐水，每组各30例。监测血流动力学，比
较术毕即刻(T0)、拔管前5 min (T1)、拔管即刻(T2)、拔管后5 min (T3)血压、心率、SpO2变化。比较术后2 h、4 h、8 h、
12 h和24 h VAS和BCS评分及不良反应。结果 A组T1、T3各时点SP、DP、MAP、HR低于B组(P<0.05)，T1、T3各
时点SP、DP、MAP、HR C组均高于A组和B组(P<0.05)，与T0时点比较，B组和C组T1、T2、T3时点SP、DP、MAP、HR明
显升高(P<0.05)。T3时点SpO2 C组均低于A、B两组，P<0.05，但其值均在97%以上，无临床意义。VAS评分术后2 h、
4 h、8 h、12 h各时点A组低于B组(P<0.05)，B组低于C组P<0.05)；BCS评分：术后2 h、4 h、8 h各时点A组高于B组
(P<0.05)，B组高于C组(P<0.05)；不良反应比较：B组恶心、呕吐率高于A、C两组(P<0.05)。结论 帕瑞昔布钠用
于鼻内镜术后镇痛效果确切，不良反应少。

      【关键词】 帕瑞昔布钠；术后镇痛；鼻内镜手术

      【中图分类号】 R765.04+1 【文献标识码】 A 【文章编号】 1003—6350（2012）11—012—03<

br>Clinial efficacy of parecoxib sodium on the postoperative analgesia of nasal endoscope surgery.
ZHOU
Dong-qing, ZHOU Qi, CHEN Li, WANG Li-yun, XIE Hai. Department of Anesthesiology, the Affiliated Hospital of
Hainan Medical College, Haikou 570102, Hainan, CHINA

【Abstract】 Objective To study the efficacy and safety of parecoxib sodium for postoperative analgesia of na-
sal endoscopic surgery. Methods Ninety ASAⅠ~Ⅱ patients undergoing nasal endoscopic surgery were randomly di-
vided into three groups, each with 30 cases. Parecoxib sodium group (group A) were injected intravenously with 40 mg parecox-
ib sodium 15 minutes before operation; Teamadol group (group B) were injected intravenously with 40 mg Teamadol
hydrochloride at the same time; saline group (group C) were injected intravenously with equivalent saline at the same
time. Hemodynamies were observed, and the blood pressure, heart rate and pulse oxygen saturation were compared be-
tween the there groups at the end of operation (T0 ), 5 minutes before extubation (T1), at the extubation (T2), and 5 min-
utes after extubation (T3). The postoperative analgesic effects were evaluated with VAS and BCS scores as well as ad-
verse effects at 2 h, 4 h, 8 h, 12 h, and 24 h after surgery. Results At T1 and T3, SP, DP, MAP, HR were significantly
lower in group A than group B (P<0.05), and those in group B was significantly lower than those in group C (P<0.05).
SD, DP, MAP, HR in group B and group C were increased significantly at the T1 ,T2 ,T3 , compared with those at T0
(P<0.05). The levels of SpO2 was lower in group C than of group A and group B at T3 (P<0.05), but the levels were all
more than 97%, with no clinical significance. VAS scores were significantly lower in group A than group B at 2 h, 4 h,
8 h, and 12 h after surgery (P<0.05), and the scores were significantly lower in group B than group C (P<0.05). BCS
scores were significantly higher in group A than group B at 2 h, 4 h, and 8 h after surgery (P<0.05), and the scores
were significantly higher in group B than group C (P<0.05). The incidence of adverse effects were significantly higher
in Group B than group A and group C (P<0.05). Conclusion Parecoxib sodium is quite effective for postoperative
analgesia of nasal endoscopic surgery, with less adverse effects.

      【Key words】 Parecoxib sodium; Postoperative analgesia; Nasal endoscopic surgery