帕瑞惜布钠及芬太尼在妇科手术预防苏醒期躁动对比.docVIP

帕瑞惜布钠及芬太尼在妇科手术预防苏醒期躁动对比【摘要】目的:探讨帕瑞昔布钠在妇科手术全麻超前镇痛及预防苏醒期躁动中的效果。方法:将32例ASA I-Ⅱ级择期妇科肿瘤手术患者随机分为治疗组与对照组各16例。2组均采用丙泊酚、雷米芬太尼复合全麻,其中治疗组于麻醉诱导前20 min静注帕瑞昔布钠40 mg,对照组麻醉诱导前20 min静注芬太尼3mg/kg。结果:治疗组的术后自主呼吸恢复时间、呼吸睁眼时间、拔管时间、苏醒期躁动例数都明显好于对照组。结论:帕瑞昔布钠用于妇科手术全麻术中可产生明显超前镇痛作用,并可预防苏醒期躁动发生,术前静注效果更好,值得临床推广 【关键词】帕瑞昔布钠;芬太尼;镇痛;苏醒期躁动 【中图分类号】R971.2 【文献标识码】A 【文章编号】1008-6455(2010)08-0229-02 The contrasting of parecoxib and fentanyl for preventing emergence agitation in the gynecological surgery Ren Lingyun Yang Jinguo 【Abstract】Objective: To investigate the effects of parecoxib and fentanyl for preventing emergence agitation in the gynecological surgery. Methods: 32 patients with ASA I-Ⅱ elective gynecological cancer surgery were randomly divided into the treatment group and the control group of 16 cases. two groups received propofol, remifentanil anesthesia, the treatment group at 20 min before induction of anesthesia intravenously parecoxibb 40 mg, the control group 20 min before induction of anesthesia, intravenous fentanyl 3mg/kg. Results: The spontaneous breathing time, breathing eye opening, extubation time, agitation number of cases of the treatment group were significantly better than the control group. Conclusion: parecoxibb for general anesthesia in gynecological surgery can produce significant preemptive analgesia, and may prevent agitation occurred, better preoperative intravenous injection, is worthy of clinical. 【Key words】Parecoxibb; fentanyl; analgesic; agitation 在妇科手术临床麻醉中,全麻后苏醒期患者的躁动一直是麻醉医生比较关注的问题。全麻后苏醒期间的躁动有许多危害。引起苏醒期患者躁动的因素是多方面的,各种有害刺激是诱发和加重躁动最常见原因。近年来提倡的多模式镇痛是将阿片类药物与其他类型的镇痛药或者神经阻滞联合应用于术后镇痛,以达到提高镇痛效果、减少不良反应的目的。帕瑞昔布钠是特异性的环氧化酶-2(COX-2)抑制剂,与传统的非选择性非甾体抗炎镇痛药相比,胃肠道不良反应及出血等并发症明显减少,可用于术后疼痛的短期治疗。我院在妇科手术结束前,停药时给予小剂量的帕瑞昔布钠并且与小剂量的芬太尼相比较取得了良好效果,现将观察结果报告如下。 1 临床资料 1.1 一般资料:随机择期妇科肿瘤手术患者32例,年龄32-74岁,平均年龄45.5岁;体重44 =75 kg,ASA I-Ⅱ级,其中胃癌18例,结肠癌10例,直肠癌4例。排除标准:(1)既往有非甾体类药物过敏史;(2)活动性消化道溃疡或胃肠道出血;(3)严重肝功能损害;(4)冠状动脉搭桥术后镇痛;(5)已确定的缺血性心脏病、外周血管或脑血管疾病。随机分为治疗组和对照组各16例。两组患者年龄、体重、疾病类型