文章摘要
王卡 田国刚 田毅 蔡仁贤 侯春燕.帕瑞昔布钠超前镇痛对妇科腹腔镜手术全凭静脉麻醉效果的影响[J].,2014,14(16):3142-3144
帕瑞昔布钠超前镇痛对妇科腹腔镜手术全凭静脉麻醉效果的影响
The Effect of Parecoxib Sodiumon the Intravenous Anesthesia withPropofol-fentanyl of Gynecological Laparoscopic Surgery
  
DOI:
中文关键词: 帕瑞昔布钠  超前镇痛  腹腔镜手术  全凭静麻  血流动力学
英文关键词: Parecoxib sodium  Preemptive analgesia  Laparoscopic surgery  Intravenous anesthesia  Haemodynamics
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作者单位
王卡 田国刚 田毅 蔡仁贤 侯春燕 海口市人民医院- 中南大学湘雅医学院附属海口医院麻醉科 
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中文摘要:
      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);③ P 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。
英文摘要:
      Objective: To evaluate the effect of parecoxib on intravenous anesthesia with propofol-fentanyl of patients undergoing gynecological laparoscopic surgery.Methods:Sixty patients (ASA ⅠorⅡ, 21053 years old, 41-72kg) who were undergoing gynecological laparoscopic surgery were selected and randomly divided into two groups:parecoxib group (group P) who were received intravenous parecoxib sodium and group NS who were received normal 0 mL before anesthesia induction for 15 min, 30 cases of each group. The same anesthetic induction method was used in the two groups. Bispectral index (BIS) was used as the index of depth of anesthesia, by which the target plasma concentration of propofol was adjusted to maintain the anesthesia. HR, MAP were recorded, recovery time, extubation time, the incidence of postoperative adverse reactions and VRS after extubation for five min were recorded.Results:①Compared with group NS, MAP at T3 to T6, HR at T3 to T5 in group P were lower, and there were statistically significant difference between two groups(P<0.05); ②The recovery time and extubation time showed no differences between group P and group NS. ③The incidence of agitation and the VRS score were decreased in group P, and there were statistically significant difference between two groups(P<0.05).Conclusion:Preemptive analgesia with parecoxib sodiumcan decrease the changes in hemodynamics,incidence of agitation and the VRS score fromintravenous anesthesia with propofol-fentanyl in patients who were undergoing gynecological laparoscopic surgery.
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