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帕瑞昔布钠超前镇痛在妇科腹腔镜手术中的应用

     

摘要

Objective To explore the safety and efficacy of preemptive analgesia with Parecoxib Na in patients undergoing gynaecological laparoscopic operation. Methods Sixty patients with ASA Ⅰ - Ⅱ scheduced for gynaecological laparoscopic operation were divided randomly into two groups : the treated group( n = 30) and the control group( n = 30) . All patients received general anesthesia. The treated group received Parecoxib Na 40mg/4ml,and the control group received physiological saline 4ml. Parecoxib Na and physiological saline were used before induction. The effect of analgesia was accessed by visual analog scale ( VAS) and the easement score was accessed by BCS at 2,6,12,24h after surgery. Side effects were also recorded. Results The patitents being injected with Parecoxib Na 40mg before induction had significantly lower VAS scores after operation than the control group ( P < 0. 05 ) . The treated group had significantly higher BCS scores after operation than the control group ( P <0. 05) . There was significant difference in the total number of injecting analgesic and the occurrence of irritability between the two groups (P <0. 05 ) . There was no significant difference in side effects between the two groups ( P > 0, 05 ) . Conclusion Preemptive analgesia with Parecoxib Na in patients who underwent gynaecological laparoscopic operation can alleriate postoperative pain obviously , and reduee the use of analgesic and the emergence of imtability with fewer side effects , so it can be safely used in clinical practice.%目的 探讨新型镇痛药帕瑞昔布钠超前镇痛用于妇科腹腔镜手术患者的安全性和有效性.方法 选择美国麻醉学会(ASA)Ⅰ~Ⅱ级,行妇科腹腔镜手术的患者60例,随机分为实验组和对照组,每组30例.均采用单纯全身麻醉.诱导前实验组将帕瑞昔布钠40mg稀释成4ml静脉注射,对照组静脉注射等量的生理盐水4ml.术后随访24h,在不同时点对患者用视觉模拟评分法(VAS)进行疼痛评分和布氏评分法(BCS)进行舒适评分,并记录术后不良反应发生情况.结果 实验组术后各时点VAS评分均显著低于对照组(P<0.05);实验组术后BCS评分均显著高于对照组(P<0.05).实验组患者使用镇痛药的例数及发生烦躁的例数均明显少于对照组(P<0.05).两组病人术后不良反应差异无统计学意义(P>0.05).结论 帕瑞昔布钠超前镇痛用于妇科腹腔镜手术患者,可明显减少术后疼痛,减少镇痛药的使用及苏醒期烦躁,且不良反应少,可以安全用于临床.

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