上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (11): 1405-.doi: 10.3969/j.issn.1674-8115.2010.11.021

• 论著（临床研究） • 上一篇    下一篇

帕瑞昔布钠术后镇痛对肝肾功能及硬膜外自控镇痛用药量的影响

王春雨1, 王士雷1, 张丕兴2   

  1. 1.青岛大学 医学院附属医院麻醉科, 青岛 266003； 2.青岛市第八人民医院麻醉科, 青岛 266100
  • 出版日期:2010-11-25 发布日期:2010-11-29
  • 通讯作者: 王士雷, 电子信箱: wshlei@yahoo.com.cn。
  • 作者简介:王春雨（1978—）, 女, 住院医师, 硕士生；电子信箱: zhutama06@126.com。

Influence of parecoxib sodium for postoperative analgesia on hepato-renal function and drug consumption of patient-controlled epidural analgesia

WANG Chun-yu1, WANG Shi-lei1, ZHANG Pi-xing2   

  1. 1.Department of Anesthesiology,The Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China；2.Department of Anesthesiology,Qingdao Eighth People's Hospital, Qingdao 266100, China
  • Online:2010-11-25 Published:2010-11-29

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摘要：

目的 观察术后帕瑞昔布钠注射液联合硬膜外自控镇痛（PCEA）对患者肝肾功能及PCEA用药量的影响。方法 在硬膜外麻醉下接受妇科手术的60例患者随机分为两组（n=30），其中帕瑞昔布钠+PCEA组患者于手术关腹后静脉注射帕瑞昔布钠40 mg后连接PCEA泵（0.005%吗啡+0.24%甲磺酸罗哌卡因），PCEA组患者则于手术关腹后仅连接PCEA泵（0.005%吗啡+0.24%甲磺酸罗哌卡因）。术后24 h检测两组患者的肝肾功能指标；于术后4、8、12和24 h时点，采用视觉模拟评分法（VAS）进行疼痛评分，同时观测PCEA按压次数和用药总量。结果 患者手术前后自身对照比较显示，肝肾功能指标均无明显变化（P>0.05）。帕瑞昔布钠+PCEA组术后4、8、12和24 h时点VAS疼痛评分及PCEA按压次数和用药总量均明显低于PCEA组，差异均有统计学意义（P<0.05或P<0.01）。两组患者均未添加其他辅助镇痛药。结论 帕瑞昔布钠用于术后镇痛对肝肾功能无明显影响，且能明显增强镇痛效果，减少PCEA用药量。

关键词: 帕瑞昔布钠, 硬膜外自控镇痛, 肝肾功能, 镇痛

Abstract:

Objective To observe the influence of postoperative application of parecoxib sodium combined with patient-controlled epidural analgesia (PCEA) on hepato-renal function and drug consumption of PCEA. Methods Sixty women undergoing epidural anesthesia were randomly divided into 2 groups (n=30). Patients in parecoxib sodium+PCEA group were intravenously injected with 40 mg parecoxib sodium after abdominal closure, and were then managed with PCEA pump (0.005% morphine+0.24% ropivacaine mesylate), while patients in PCEA group were only managed with PCEA pump (0.005% morphine+0.24% ropivacaine mesylate) after abdominal closure. Parameters of hepato-renal function were measured 24 h after operation. Visual analogue scale (VAS) scores were obtained 4, 8, 12 and 24 h after operation, and palping times of PCEA and drug consumption of PCEA were recorded meanwhile. Results There was no significant change in parameters of hepato-renal function after operation in both groups（P>0.05）. VAS scores, palping times of PCEA and drug consumption of PCEA 4, 8, 12 and 24 h after operation in parecoxib sodium+PCEA group were significantly lower than those in PCEA group（P<0.05 or P<0.01）. There was no additional analgesic medication for both groups. Conclusion Parecoxib sodium for postoperative analgesia has no significant influence on hepato-renal function, while it can obviously enhance the analgesic effect and decrease the drug consumption of PCEA.

Key words: parecoxib sodium, patient-controlled epidural analgesia, hepato-renal function, analgesia