国际麻醉学与复苏杂志   2011, Issue (4): 9-9
    
帕瑞昔布结合切口局麻用于腹腔镜胆囊切除术后的镇痛效果
陆慧红, 白浪, 刘宗奇1()
1.北京平凡心语广告有限公司
The postoperative analgesic effect of parecoxib following laparoscopic cholecystectomy when combined with incision infiltration by local anesthetics
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摘要:

目的:观察帕瑞昔布结合切口局麻用于腹腔镜胆囊切除术后的镇痛效果。方法:选择全麻下行腹腔镜胆囊切除术患者50例,随机分为特耐组和对照组,每组25例。术前10分钟实验组静注特耐40 mg,对照组静注同等容量的生理盐水。所有病例均于切皮前在脐部切口处以0.5%布比卡因8ml全层浸润。观察时间点为:T1(离开PACU时),T2(术后5小时)和T3(手术次日晨)。比较两组患者VAS值、是否要求额外给予阿片类药物镇痛、整体镇痛质量的满意认可及对睡眠质量的满意认可。结果:在T1、T2时间点,特耐组的VAS评分显著低于对照组(T1:1.6±0.5 vs 3.6±0.7,T2:1.8±0.6 vs 3.5±0.9,P<0.05);在T3特耐组的VAS评分略低于对照组,但差异无统计学意义。对照组要求病房医生予以镇痛治疗者显著多于特耐组(P<0.05),对整体镇痛质量的满意率和睡眠质量满意率在特耐组均显著高于对照组(P<0.05)。结论:特耐联合切口局部浸润麻醉在腹腔镜胆囊切除术后可以提供良好的镇痛效果。

关键词: 帕瑞昔布;腹腔镜胆囊切除术
Abstract:

Objective To investigate the postoperative analgesic effect of parecoxib following laparoscopic cholecystectomy when local anesthetics was infilltrated at incision site. Methods Fifty patients undergoing laparoscopic cholecystectomy were randomized, double-blind divided into two groups: patients in the experimental group received intravenous parecoxib 40mg 10 minutes before operation, and patients in the control group received intravenous physiological saline in same volume. All the patients received incision infiltration with 0.5% bupivacaine 8ml at navel before the operations. The observation time points included T1(departure from the PACU), T2( 5 hours after the operation) and T3(the morning of postoprative day 1). VAS values, additional requirement of opioids analgesia, the rate of satisfactory with analgesia quality and sleep quality was compared between two groups. Results: The VAS values in the experimental group were significantly lower than in the control group at T1 and T2 (T1:1.6±0.5 vs 3.6±0.7,T2:1.8±0.6 vs 3.5±0.9,P<0.05), while VAS was lower in the experimental group at T3, but the difference had no Statistical significance . The rate of satisfactory with analgesia and sleep quality in the experimental group was significantly higher than in the control group. Conclusion Paricoxib combined with incision infiltration can significantly relieve the postoperative pain in the patients receiving laparoscopic cholecystectomy.

Key words: Parecoxib; cholecystectomy,Laparoscopic