上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (2): 196-.doi: 10.3969/j.issn.1674-8115.2013.02.014

• 论著（临床研究） • 上一篇    下一篇

帕瑞昔布钠对乳腺癌改良根治术患者术后镇痛的效果

储晓英, 夏一梦, 张富军, 伍明明   

  1. 上海交通大学 医学院附属瑞金医院麻醉科, 上海 200025
  • 出版日期:2013-02-28 发布日期:2013-03-07
  • 通讯作者: 伍明明, 电子信箱: wumingming66@126.com。
  • 作者简介:储晓英（1974—）, 女, 主治医师, 硕士生；电子信箱: shirleychu@sina.com。

Effects of parecoxib sodium on analgesia after radical mastectomy for breast cancer

CHU Xiao-ying, XIA Yi-meng, ZHANG Fu-jun, WU Ming-ming   

  1. Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2013-02-28 Published:2013-03-07

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摘要：

目的 比较不同时间点给予帕瑞昔布钠对乳腺癌改良根治术患者术后镇痛效果的影响。方法 选取全身麻醉下行乳腺癌改良根治术患者60例，分为4组，每组15例：A组麻醉诱导同时给予2 mL生理盐水，B组麻醉诱导同时予帕瑞昔布钠40 mg，C组缝皮前给予帕瑞昔布钠40 mg，D组麻醉诱导同时和缝皮前分别给予帕瑞昔布钠40 mg，帕瑞昔布钠均用生理盐水稀释成2 mL静脉注射。苏醒期根据患者主诉追加芬太尼至患者满意。记录术后2、12和24 h患者的视觉模拟疼痛评分（VAS），24 h VAS运动评分和镇痛满意率，以及术后恶心、呕吐情况。结果 B、C、D组术后2、12、24 h VAS评分均显著低于A组（P<0.01）， B组和D组术后12 h VAS评分均显著低于C组（P<0.05）。B、C、D组术后24 h VAS运动评分均显著低于A组（P<0.01），B组术后24 h VAS运动评分显著高于D组（P<0.05）。B、C、D组术后24 h镇痛满意率均高于A组。B、C、D组术后12、24 h恶心、呕吐发生率低于A组。结论 帕瑞昔布钠对乳腺癌改良根治术患者具有超前镇痛作用，可提高患者术后镇痛效果和镇痛满意率，减少术后恶心、呕吐发生率；麻醉诱导同时和缝皮前均给予帕瑞昔布钠可能效果更佳。

关键词: 帕瑞昔布钠, 术后镇痛, 恶心呕吐

Abstract:

Objective To investigate the effects of administration of parecoxib sodium at different time points on analgesia after modified radical mastectomy for breast cancer. Methods Sixty patients undergoing modified radical mastectomy for breast cancer under general anesthesia were selected and divided into four groups, with 15 patients in each group. Group A received 2 mL normal saline during anesthesia induction, group B 40 mg parecoxib sodium during anesthesia induction, group C 40 mg parecoxib sodium at the end of surgery, and group D 40 mg parecoxib sodium both during anesthesia induction and at the end of surgery. Parecoxib sodium was intravenously administered after dilution into 2 mL normal saline in group B, group C and group D. Fentanyl was supplemented to the requirement of patients during analepsia. Visual analogue scale (VAS) scores were recorded 2, 12 and 24 h after surgery, VAS motion scores and analgesic satisfaction rates were obtained 24 h after surgery, and the occurrence of nausea and vomiting were observed after surgery. Results The VAS scores 2, 12 and 24 h after surgery in group B, group C and group D were significantly lower than those in group A (P<0.01), and the VAS scores 12 h after surgery in group B and group D were significantly lower than those in group C (P<0.05). The VAS motion scores 24 h after surgery in group B, group C and group D were significantly lower than that in group A (P<0.01), and the VAS motion score 24 h after surgery in group B was significantly higher than that in group D (P<0.05). The analgesic satisfaction rates 24 h after surgery in group B, group C and group D were higher than that in group A. The prevalences of nausea and vomiting 12 and 24 h after surgery in group B, group C and group D were lower than those in group A. Conclusion Parecoxib sodium plays a role in preemptive analgesia for patients undergoing modified radical mastectomy for breast cancer, which may improve postoperative pain control and analgesic satisfaction rate and reduce the incidence of nausea and vomiting. Administration of parecoxib sodium both during anesthesia induction and at the end of the surgery may yield better results.

Key words: parecoxib sodium, postoperative analgesia, nausea and vomiting