帕瑞昔布用于食道癌根治术后镇痛的临床研究

摘要

目的 研究帕瑞昔布对食道癌根治术后疼痛以及纵膈积血引流量的影响.方法 将68例食道癌根治术患者随机平均分为帕瑞昔布组和对照组,帕瑞昔布组于术前15 min静脉给予帕瑞昔布40 mg,对照组给予等量生理盐水.所有患者采用左侧双腔气管导管插管全身麻醉.术后采用患者静脉自控镇痛(舒芬太尼2.5 μg/kg+托烷司琼5mg+生理盐水稀释至100 mL).分别评估术后2、6、12、24、48 h的镇痛效果,同时观察术后24、48 h纵膈积血引流量情况.结果 术后各时点静息状态下视觉模拟评分(VAS)两组间差异无统计学意义；但咳嗽时对照组VAS评分显著高于实验组(P＜0.05).术后24、48 h纵膈积血引流量两组间差异无统计学意义.结论 帕瑞昔布用于食道癌根治术增强了术后镇痛的效果,同时并不增加纵膈积血量.%Objective To investigate the effect of parecoxib on postoperative pain and mediastinum hemorrahage lead flow in patients undergoing radical resection of esophagus cancer. Methods Sixty-eight patients scheduled for radical resection of esophagus cancer were randomly allocated to parecoxib group (Group T, n = 34) and Control group (Group C, n = 34). A dose of 40 mg parecoxib was administered i. v 15 min before surgery in Group T, while the same dose of saline was administered in Group C. All patients were performed general anesthesia with left double-lumen tube intubated. All patients were treated with PCIA post-operatively (sufentanyl 2. 5 μg/kg + tropisetron 5 mg + normal saline/100 mL). Analgesic effect was evaluated by visual analog scale (VAS) 2, 6, 12, 24, 48 h after surgery, and the mediastinum hemorrahage lead flow 24,48h after surgery was observed. Results There was no significant difference between VAS at rest at every time point postoperatively in the two groups, while the VAS was significantly higher in the control group than in parecoxib group when coughing occurs. There was no significant difference between the mediastinum hemorrahage lead flow 24,48h after surgery in the two groups. Conclusion Pre-operative parecoxib administration can improve analgesic effect after radical resection of esophagus cancer, meanwhile it does not increase the mediastinum hemorrahage lead flow.