静脉注射帕瑞昔布钠对瑞芬太尼复合麻醉术后早期疼痛和阿片类药物不良反应发生率的影响研究

摘要

Objective:To explore the influence of intravenous injection of parecoxib sodium on early pain and incidence of ad-verse reactions of opioid drugs after remifentanil combined anesthesia.Methods:80 patients with combined anesthesia operation were selected.They were randomly divided into the A group,B group,C group and D group.The A group and B group used intrave-nous anesthesia;the C group and D group used inhalation anesthesia.All patients were given penehyclidine,midazolam,etomidate, cisatracurium and remifentanil for induced anesthesia,before surgery and at the end of the operation.The A group and C group were given intravenous injection of parecoxib sodium.We compared the difference among the four groups.Results:During 24 hours after operation,the VAS score of the C group and D group was higher than the A group and B group(P<0.05);there was no signifi-cant difference in the incidence of adverse reactions among the four groups(P>0.05).Conclusion:Before the end of surgery,intra-venous injection of parecoxib sodium can reduce postoperative pain after remifentanil combined anesthesia.Intravenous anesthe-sia can better prevent remifentanil induced pain,reduce adverse reactions,and the safety is higher.%目的：探讨静脉注射帕瑞昔布钠对瑞芬太尼复合麻醉术后早期疼痛和阿片类药物不良反应发生率的影响。方法：收治复合麻醉手术患者80例，随机分为甲组、乙组、丙组和丁组，甲、乙组为静脉麻醉，丙、丁组为吸入麻醉，全部患者均给予长托宁、咪达唑仑、依托咪酯、顺式阿曲库铵、瑞芬太尼诱导麻醉，手术开始及结束前，甲组和丙组给予帕瑞昔布钠静脉注射，比较组间差异。结果：术后24 h内，丙组和丁组VAS评分高于甲组和乙组(P＜0.05)，4组患者不良反应发生率比较，差异无统计学意义(P＞0.05)。结论：手术结束前给予帕瑞昔布钠静脉注射可减轻瑞芬太尼复合麻醉术后疼痛，静脉麻醉可更好地预防瑞芬太尼诱发痛觉过敏，减少不良反应，安全性更高。