论文部分内容阅读
目的:评价帕瑞昔布钠超前镇痛对妇科腹腔镜手术异丙酚-芬太尼静脉麻醉效果的影响。方法:选择在我院行妇科腹腔镜手术的患者60例,ASA分级为Ⅰ级或Ⅱ级,年龄分布在21-53岁,体重为41-72 kg。将所有患者随机分为帕瑞昔布钠组(P组)和生理盐水组(NS组),每组各30例。在麻醉诱导前15 min,对P组患者采取静脉注射帕瑞昔布钠40 mg,NS组患者则采取静脉注射等容积的生理盐水。两组麻醉诱导方法相同,术中以脑电双频指数(bispectral index,BIS)为麻醉深度指标,根据BIS值调节异丙酚血浆靶浓度以维持麻醉。记录拔管期间患者的心率(HR),平均动脉压(MAP)变化情况,苏醒时间,拔管时间,苏醒期不良反应及拔管后5 min疼痛VRS评分。结果:①两组患者血流动力学平稳,P组在T3至T6各时点的MAP和T3至T5各时点的HR均明显低于NS组,差异有统计学意义(P<0.05);②两组苏醒时间和拔管时间无明显差别(P>0.05);P组苏醒期躁动发生率为10%,明显低于NS组的26.7%,差异有统计学意义(P<0.05);③P组拔管后5 min疼痛VRS评分为2.0,明显低于NS组的3.6,差异有统计学意义(P<0.05)。结论:帕瑞昔布钠超前镇痛能减轻异丙酚-芬太尼静脉麻醉下妇科腹腔镜手术过程中血流动力学波动,减少苏醒期躁动的发生和疼痛VRS评分。
OBJECTIVE: To evaluate the effect of parecoxib sodium in preemptive analgesia on the anesthetic effect of propofol-fentanyl in gynecologic laparoscopic surgery. Methods: Sixty patients with gynecological laparoscopic surgery underwent gynecologic laparoscopic surgery in our hospital. The ASA grade was grade Ⅰ or Ⅱ, with a mean age of 21-53 years and a body weight of 41-72 kg. All patients were randomly divided into parecoxib sodium group (P group) and saline group (NS group), 30 cases in each group. Intravenous injection of parecoxib sodium 40 mg was given to patients in group P at 15 min before induction of anesthesia, and an equal volume of saline was injected intravenously into patients in NS group. The anesthesia induction methods were the same in both groups. Bispectral index (BIS) was used as the indicator of anesthesia depth. The target plasma concentration of propofol was adjusted according to BIS to maintain anesthesia. The heart rate (HR), mean arterial pressure (MAP), recovery time, extubation time, awakening adverse reactions and pain VRS score at 5 min after extubation were recorded during extubation. Results: ① The hemodynamics of both groups were stable. The HR of MAP and T3 to T5 at each time point from T3 to T6 in P group were significantly lower than those in NS group (P <0.05). (2) There was no significant difference between the two groups in recovery time and extubation time (P> 0.05). The incidence of restlessness in P group was 10%, significantly lower than that in NS group (26.7%, P <0.05) VRS score was 2.0 at 5 min after extubation, which was significantly lower than that of NS at 3.6 (P <0.05). Conclusion: Parecoxib sodium preemptive analgesia can reduce hemodynamic fluctuation during gynecologic laparoscopic surgery under propofol-fentanyl venous anesthesia and reduce the onset of agitation and pain VRS score.