Karolinska Institutet, Institution for Physiology & Pharmacology, Department of Anaesthesia & Intensive Care, Foot & Ankle Surgical Centre, Stockholm, Sweden.
J Orthop Surg Res. 2008 Sep 11;3:40. doi: 10.1186/1749-799X-3-40.
Anti-inflammatory drugs, NSAIDs, have become an important part of the pain management in day surgery. The aim of the present study was to evaluate the effect of Coxib premedication on the intra-operative anaesthetic requirements in patients undergoing elective ankle surgery in general anaesthesia.
Prospective, randomized study of the intra-operative anaesthetic-sparing effects of etoricoxib premedication as compared to no NSAID preoperatively.
The intra-operative requirement of sevoflurane was studied in forty-four ASA 1-2 patients undergoing elective ankle day surgical in balanced general anaesthesia. Primary study endpoint was end-tidal sevoflurane concentration to maintain Cerebral State Index of 40-50 during surgery.
All anaesthesia and surgery was uneventful, no complications or adverse events were noticed. The mean end-tidal sevoflurane concentration intra-operatively was 1.25 (SD 0.2) and 0.91 (SD 0.2) for the pre and post-operative administered group of patients respectively (p < 0.0001). No other intra-operative differences could be noted. Emergence and recovery was rapid and no difference was noticed in time to discharge-eligible mean 52 minutes in both groups studied. In all 6 patients, 5 in the group receiving etoricoxib post-operatively, after surgery, and one in the pre-operative group required rescue analgesia before discharge from hospital. No difference was seen in pain or need for rescue analgesia, nausea or patients satisfaction during the first 24 postoperative hours.
Coxib premedication before elective day surgery has an anaesthetic sparing potential.
抗炎药（NSAIDs）已成为日间手术疼痛管理的重要组成部分。本研究旨在评估 Coxib 术前用药对接受全身麻醉下择期踝关节手术患者术中麻醉需求的影响。
与术前无 NSAID 相比，Coxib 术前用药对术中麻醉节省效果的前瞻性、随机研究。
在 44 例接受择期踝关节日间手术的 ASA 1-2 患者中，研究了平衡全身麻醉下七氟醚的术中需求。主要研究终点是手术期间维持脑状态指数 40-50 所需的呼气末七氟醚浓度。
所有麻醉和手术均无并发症或不良反应。术中平均呼气末七氟醚浓度分别为术前组患者的 1.25（SD 0.2）和术后组患者的 0.91（SD 0.2）（p <0.0001）。未注意到其他术中差异。苏醒和恢复迅速，两组研究的出院合格时间平均为 52 分钟，无差异。在所有 6 例患者中，术后接受依托考昔的 5 例患者在手术后，以及术前组的 1 例患者在出院前需要进行解救性镇痛。在术后 24 小时内，疼痛或需要解救性镇痛、恶心或患者满意度方面无差异。
择期日间手术前使用 Coxib 进行术前用药具有麻醉节省潜力。
