超前镇痛及规律性给药对缓解腰椎管狭窄症术后疼痛效果的临床研究中西骨伤科学专业论文.docxVIP

PAGE PAGE 10 Clinical Observation The Effect of Preemptive Analgesia and Regular Administration on Postoperative Pain of Spinal Stenosis after surgery Abstract Objective: Observe the use of celecoxib cloth preemptive analgesia and regularity of the timely administration of lumbar spinal stenosis postoperative pain efficacy study. Methods: select the window from March 2010 to January 2012, admitted posterior lamina nucleus pulposus, nerve root canal augmentation 60 cases of lumbar spinal canal stenosis were randomly divided into two groups: group A (observation group) and group B (control group) (n = 30 cases), postoperative pain VAS score was observed after analgesic treatment through different methods of analgesia, opioid consumption, coagulation index changes and postoperative adverse events. Results: VAS score of group A at different time points were lower than group B, the difference was significant (P 0.05); in the day after surgery and on postoperative days 3, group A the use of opioids less frequently than the control groupchanges in coagulation in the two groups before and after surgery (P 0.05); the number of adverse reactions was lower than the control group, but there was no significant difference (P 0.05), no significant difference (P 0.05). Conclusion: celecoxib cloth ahead and regularity of time and administration of the analgesic effect of lumbar spinal stenosis surgery can reduce postoperative opioid use, and reduce postoperative adverse reactions; without affecting the patients coagulation . Key words: Celecoxib; Preemptive analgesia; Lumbar spinal stenosis; Analgesic. 引 言 术后疼痛是手术后患者最常见的症状之一，国际疼痛研究协会 （IASP）给疼痛定义为：疼痛是机体伴随现有的或潜在的组织损伤而产 生的生理和心理等因素复杂结合的主观感受。故术后疼痛使得一部分患 者因疼痛导致焦虑致交感神经兴奋,可引起心动过速、耗氧增加、诱发心 脏病，抑制机体的免疫调节和正常的胃肠功能;引起神经内分泌与代谢功 能失调;导致血液高凝状态,并影响病人的精神状态。严重的术后疼痛往 往使骨关节手术病人不愿意进行肢体活动及功能锻炼,从而引起活动不 足,导致关节肌肉功能废用、关节僵硬,最终导致工作及生活质量下降的 永久性损害[1]。因此施行超前及规律性给药对于术后镇痛是非常重要的。 阿片类止痛药物( 哌替啶、吗啡、曲马多等) 是手术后止痛的常用药物, 但手术后单纯使用这类止痛药存在止痛不完全、容易引起恶心和呕吐等 不良反应, 且使用阿片类止