Turan A, Emet S, Karamanlioğlu B, Memiş D, Turan N, Pamukcu Z
Department of Anaesthesiology, Trakya University Medical Faculty, 22030 Edirne, Turkey.
Anesth Analg. 2002 Nov;95(5):1308-11, table of contents. doi: 10.1097/00000539-200211000-00039.
In this study we evaluated the analgesic efficacy and the opioid-sparing effect of rofecoxib in ear-nose-throat surgery patients. Patients undergoing nasal septal or sinus surgery were randomized to receive either oral placebo or rofecoxib 50 mg 1 h before surgery. All patients received propofol 0.8 mg/kg, fentanyl 1 microg/kg, and local anesthesia at the operative site. Sedation was maintained by a continuous infusion of propofol adjusted to maintain sedation at a 2-3 level on the Ramsey scale. Additional fentanyl 0.5-1 microg/kg was administered at the patient's request or if the verbal rating scale score was >4. Patient sedation and pain scores were obtained at 5, 15, 30 45, and 60 min during surgery and 30 min and 2, 4, 6, 12, and 24 h after completion of the procedure. During the postoperative period, diclofenac 75 mg IM was administered for analgesia at the patient's request or if the visual analog scale (VAS) rating for pain was more than 4. VAS pain scores, intraoperative fentanyl, and postoperative diclofenac requirements were significantly smaller in the rofecoxib group compared with the placebo group (P < 0.001). The times to first analgesic request were also significantly less in the rofecoxib group. We conclude that the preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.
The aim of this study was to evaluate the analgesic efficacy and opioid-sparing effect of rofecoxib, a new selective cyclooxygenase-2 inhibitor drug, in ear-nose-throat surgery patients. Preoperative administration of oral rofecoxib provided a significant analgesic benefit and decreased the need for opioids in patients undergoing nasal septal and nasal sinus surgery.
在本研究中，我们评估了罗非昔布在耳鼻喉科手术患者中的镇痛效果及阿片类药物节省效应。接受鼻中隔或鼻窦手术的患者被随机分为两组，一组在手术前1小时口服安慰剂，另一组口服50毫克罗非昔布。所有患者均接受0.8毫克/千克丙泊酚、1微克/千克芬太尼，并在手术部位进行局部麻醉。通过持续输注丙泊酚来维持镇静，根据拉姆齐量表将镇静水平维持在2 - 3级。根据患者需求或言语评定量表评分>4时，追加0.5 - 1微克/千克芬太尼。在手术期间的5、15、30、45和60分钟以及手术结束后30分钟、2、4、6、12和24小时记录患者的镇静和疼痛评分。在术后期间，根据患者需求或视觉模拟量表（VAS）疼痛评分超过4分时，给予75毫克双氯芬酸肌内注射用于镇痛。与安慰剂组相比，罗非昔布组的VAS疼痛评分、术中芬太尼用量及术后双氯芬酸需求量均显著更低（P < 0.001）。罗非昔布组首次要求镇痛的时间也显著更短。我们得出结论，术前口服罗非昔布为接受鼻中隔和鼻窦手术的患者提供了显著的镇痛益处，并减少了阿片类药物的需求。
本研究的目的是评估新型选择性环氧化酶 - 2抑制剂药物罗非昔布在耳鼻喉科手术患者中的镇痛效果及阿片类药物节省效应。术前口服罗非昔布为接受鼻中隔和鼻窦手术的患者提供了显著的镇痛益处，并减少了阿片类药物的需求。
