The effect of parecoxib sodium for preemptive analgesia on nasal endoscopic surgery
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摘要: 目的:观察新一代选择性环氧化酶-2抑制剂帕瑞昔布钠不同时间点应用于鼻内镜手术患者的术中及术后镇痛效果,为临床合理应用预防性镇痛药物提供参考。方法:采用随机、双盲、对照设计,将120例局部麻醉鼻内镜下行鼻中隔偏曲矫正+鼻甲射频消融术患者分为术前帕瑞昔布钠镇痛组(A组)、术前及术后帕瑞昔布钠镇痛组(B组)及对照组(C组),每组40例。A组术前30 min单次肌内注射帕瑞昔布钠40 mg,术后24、48 h给予相同体积生理盐水肌内注射;B组于术前30 min及术后24、48 h肌内注射帕瑞昔布钠40 mg;C组在与A、B组相同的时间段内给予相同容积生理盐水肌内注射。采用视觉模拟评分法(VAS)评估3组患者术中及术后3、24、48 h的疼痛情况,同时记录术后追加镇痛药使用情况及药物相关不良反应发生情况。结果:与C组相比,A组与B组在术中及术后3、24、48 h的VAS评分均显著降低(P<0.05)。在术后24 h VAS评分上,A组显著高于B组(P<0.05);在术中及术后3 h评分上,A组与B组之间差异无统计学意义(P>0.05)。A、B组患者术后48 h VAS评分中位数为0,说明疼痛控制良好,2组之间差异无统计学意义(P>0.05)。与C组相比,A组与B组术后追加镇痛药使用率减少(P<0.05),而A、B组之间术后追加镇痛药使用率差异无统计学意义(P>0.05),且2组术后均未见药物相关不良反应的发生。结论:帕瑞昔布钠应用于局部麻醉鼻内镜鼻中隔偏曲矫正+鼻甲射频消融术可获得良好的术中及术后镇痛效果,术前结合术后用药的预防性镇痛模式对术后疼痛控制效果好于单纯术前用药。Abstract: Objective: To evaluate the perioperative analgesic effects of parecoxib sodium in patients undergoing nasal endoscopic surgery.Method: In the randomized, double blind, controlled study, 120 patients undergoing septoplasty were divided into 3 groups (n=40): A group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by saline at the same volume every 24 h for 48 h;B group received parecoxib at a dose of 40 mg by muscle injection 30 min before the operation followed by 40 mg every 24 h for 48 h; C group received an equal volume of 0.9% saline at the same time points. Patients were assessed with respect to pain score (VAS),rescue analgesia requirement and the side effects during the operation as well as at 3,24,48 h after the surgery.Result: Intra-operative as well as the postoperative pain scores were less in the A group and B group than in the control group. Compared with group A, group B had significantly lower VAS score at 24 h after the operation, however there were no significant difference on other time points. Fewer participants of both the A and B groups required rescue medication after operation. Conclusion: Administration of parecoxib can provide ideal analgesic effects without serious adverse side effects at the perioperative period for patients who received nasal endoscopic operation. Intramuscular parecoxib (40 mg 30 min before the operation followed 40 mg qd for 48 h) designed as preoperative analgesia mode resulted in sufficient perioperative analgesia that deserves popularization in the clinical works.
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[1] MARTINEZ V,BELBACHIR A,JABER A,et al.The influence of timing of administration on the analgesic efficacy of parecoxib in orthopedic surgery[J]. Anesth Analg,2007,104:1521-1527.
[2] POGATZKI-ZAHN E M,ZAHN P K.From preemptive to preventive analgesia[J].Curr Opin Anaesthesiol,2006,19:551-555.
[3] REUBEN S S,EKMAN E F,CHARRON D.Evaluating the analgesic efficacy of administering celecoxib as a component of multimodal analgesia for outpatient anterior cruciate ligament reconstruction surgery[J].Anesth Analg,2007,105:222-227.
[4] KHALILI G,JANGHORBANI M,SARYAZDI H,et al.Effect of preemptive and preventive acetaminophen on postoperative pain score: a randomized, double-blind trialof patients undergoing lower extremity surgery[J].J Clin Anesth,2013,25:188-192.
[5] NONG L,SUN Y,TIAN Y,et al.Effects of parecoxib on morphine analgesia after gynecology tumor operation: a randomized trial of parecoxibused in postsurgical pain management[J].J Surg Res,2013,183:821-826.
[6] 朱剑,黄烽. 选择性COX-2抑制剂临床应用新进展[J].中国新药杂志,2009,18(6):497-498.
[7] LLOYD R,DERRY S,MOORE R A,et al.Intravenous or intramuscular parecoxib for acute postoperative pain in adults[J]. Cochrane Database Syst Rev,2009,15:CD004771.
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