国际麻醉学与复苏杂志   2018, Issue (12): 0-0
    
帕瑞昔布钠对经尿道膀胱肿瘤切除术术后尿管相关膀胱刺激征的预防作用
黄岚, 刘功俭1()
1.徐州医科大学附属医院
Efficacy of parecoxib for the prevention of catheter-related bladder discomfort after transurethral resection of bladder
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摘要:

目的 观察术中使用帕瑞昔布钠对经尿道膀胱肿瘤切除术(transurethral resection of bladder tumor, TURBT)术后尿管相关膀胱刺激征(catheter-related bladder discomfort, CRBD)的预防作用。 方法 择期全身麻醉下行TURBT男性患者56例,按照随机数表法分为对照组(C组)和帕瑞昔布钠组(P组),每组28例。两组患者麻醉方案一致,在预计手术结束前10 min时,P组静脉注射帕瑞昔布钠40 mg,C组给予等体积0.9%氯化钠注射液。观察患者拔管后5 min(T1)、1 h(T2)、6 h(T3)和12 h(T4)的CRBD发生率与程度、疼痛程度(VAS评分)、意识状态(Ramsay 评分)、药物追加情况、不良反应发生情况及患者满意度。 结果 P组 在T1、T2和T3时点CRBD的发生率明显低于C组(89.3%比46.4%,89.3%比35.7%,67.9%比39.3%)(P<0.05),且CRBD的严重程度低于C组(P<0.05);P组术后各个观察时点的VAS评分低于C组(P<0.05);两组Ramsay评分、患者满意度、术后追加的药物及不良反应差异无统计学意义(P>0.05)。 结论 术中帕瑞昔布钠单次给药能降低TURBT患者术后早期CRBD发生率,减轻CRBD的严重程度,镇痛效果确切,药物不良反应少。

关键词: 帕瑞昔布钠; 尿管相关膀胱刺激征; 经尿道膀胱肿瘤切除术
Abstract:

Objective The aim of this study was to assess the prevention profiles of parecoxib on catheter-related bladder discomfort (CRBD) after transurethral resection of bladder tumor(TURBT). Methods Fifty-six male adult patients undergoing transurethral resection of bladder tumor were enrolled. Induction and maintenance of anesthesia were standardized. Patients were randomly divided into two groups according to the random number table method that received either intravenous 0.9% NaCl solution [control group (group C)] or parecoxib (40 mg) (group P) at 10 min before the end of the operation. The incidence and severity of CRBD, postoperative pain, Ramsay scores, patient satisfaction, postoperative additional drugs and adverse effects were assessed at 5 min (T1), 1 h (T2), 6 h (T3) and 12 h (T4) after administration of the parecoxib by another observer who does not know research grouping situation. Results The incidence of CRBD in group P at T1, T2 and T3 was significantly lower than that in group C (89.3% vs 46.4%, 89.3% vs 35.7%, 67.9% vs 39.3%)(P<0.05), and the severity of CRBD in group P is lower than that of group C (P<0.05). Visual Analogue Scale(VAS) scores of group P at each observation time point were lower than those in group C(P<0.05). Ramsay scores, patient satisfaction, postoperative additional drugs and adverse reactions were no significant difference between the two groups (P>0.05). Conclusions Not only can a single intravenous injection of parecoxib 40 mg at the end of surgery effectively reduce the incidence and severity of postoperative CRBD in patients with TURBT, but also has certain analgesic effect without causing serious adverse reaction.

Key words: Parecoxib; Catheter-related bladder discomfort; Transurethral resection of bladder tumor