帕瑞昔布钠用于上肢骨折手术对芬太尼术后镇痛效果的影响(1)
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[摘要] 目的 探讨帕瑞昔布钠用于上肢骨折手术对芬太尼术后镇痛效果的影响。方法 将90例患者分为对照组和实验组，在手术结束前15min，对照组患者给予静脉注射2mL生理盐水，实验组患者给予静脉注射40mg帕瑞昔布钠。结果 术后5、7、11h组间VAS评分比较差异有统计学意义(P<0.05)；术后2、24h两组间的VAS评分比较，差异无统计学意义(P>0.05)；与对照组相比，实验组患者镇痛泵按压次数以及镇痛泵外芬太尼静脉追加次数明显低于对照组，差异有统计学意义(P<0.05)；实验组患者嗜睡、恶心等不良症状的发生率较低(P<0.05)。结论 帕瑞昔布钠能够有效减少上肢骨折手术芬太尼静脉镇痛的不良反应以及有效提高术后镇痛效果，具有安全性和有效性。
[关键词] 帕瑞昔布钠；上肢骨折手术；芬太尼；镇痛效果
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2011)34-98-02
The Influence of Parecoxib Sodium on the Postoperative Analgesic Effect of Fentanyl for Upper Limb Fracture Surgery
LIU Dong
Dali Hospital of Nanhai District of Foshan City in Guangdong Province，Foshan 528231，China
[Abstract] Objective To explore the influence of parecoxib sodium on the postoperative analgesic effect of fentanyl for upper limb fracture surgery. Methods Ninty cases were were divided into control and experimental groups, 15min before the end of surgery, the control group was treated with intravenous saline 2mL and the experimental group was treated with intravenous parecoxib sodium 40mg. Results Postoperative 5，7，11 hours，VAS scores between groups had statistically significant difference(P<0.05)；Postoperative 2，24 hours，VAS scores between the two groups had no statistically significant difference(P>0.05)；Comparing with the control group，the press numbers of analgesic pump and additional number of intravenous fentanyl outside the analgesic pump of experimental group were significantly lower than those of the control group, and the differences were statistically significant(P<0.05)；The incidences of drowsiness，nausea and other adverse symptoms of experimental group were lower(P<0.05). Conclusion Parecoxib sodium can effectively reduce the adverse effects of fentanyl for upper limb fracture surgery and effectively improve the analgesic effect, with the safety and effectiveness.
[Key words] Parecoxib sodium；Upper limb fracture surgery；Fentanyl；Analgesic effect
术后良好镇痛可有效减轻术后的应激反应，近年来非阿片类药物在术后镇痛领域应用日渐增多[1]。帕瑞昔布钠是在国内新上市的非甾体抗炎镇痛药，它是全球第一种注射用的选择性环氧合酶(COX-2)抑制剂[2]，帕瑞昔布钠已在临床麻醉中应用于妇科、骨科及腹部手术的疼痛治疗，并且显示出良好的镇痛效果和更少的副作用[3]。本文通过对帕瑞昔布钠用于上肢骨折手术对芬太尼术后的镇痛效果观察，分析总结如下。
1 资料与方法 ......
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