Wang Qing, Li Zhen, Wang Zhi-peng, Cui Can
Department of Anesthesiology, Guangdong General Hospital/Guangdong Academy of Medical Sciences, Guangzhou 510080, China. wqzly@ hotmail.com
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Nov;30(11):2556-7.
To investigate the preemptive analgesic efficiency of parecoxib in patients undergoing laparoscopic colorectal surgery.
Forty ASA I-II patients aged 30 to 64 years undergoing laparoscopic colorectal surgery were randomized to receive either intravenous parecoxib sodium (40 mg) at anesthesia induction (group A) or intravenous parecoxib sodium (40 mg) 30 min before the completion of surgery (group B). Butorphanol was administered by patient-controlled analgesia for postoperative analgesia. The intensity of pain measured by VAS score was recorded at 2, 4, 6, 8, 12, and 24 h after the operation. The number of unsatisfied demand and the number of successfully delivered doses, butorphanol consumption at 12 h and 24 h after the operation, the patients' global evaluation of the postoperative analgesia and the number of the patients receiving rescue medication and adverse effects related to analgesia were recorded and compared between the two groups.
The VAS scores at different time points were significantly lower in group A than in group B (P<0.05). The number of unsatisfied demand and the number of successfully delivered doses were significantly higher and butorphanol consumption at 12 h and 24 h after the operation was significantly less in group A (P<0.05). The incidence of adverse events was similar between the two groups.
Administration of 40 mg parecoxib sodium at anesthesia induction in the patients undergoing laparoscopic colorectal surgery can result in significant preemptive analgesia.
探讨帕瑞昔布对腹腔镜结直肠手术患者的超前镇痛效果。
将40例年龄在30至64岁、美国麻醉医师协会（ASA）分级为I-II级、行腹腔镜结直肠手术的患者随机分为两组，A组于麻醉诱导时静脉注射帕瑞昔布钠（40mg），B组于手术结束前30分钟静脉注射帕瑞昔布钠（40mg）。术后采用患者自控镇痛法给予布托啡诺进行镇痛。记录术后2、4、6、8、12和24小时采用视觉模拟评分法（VAS）测量的疼痛强度。记录并比较两组患者的镇痛需求未满足次数、有效给药次数、术后12小时和24小时的布托啡诺用量、患者对术后镇痛的总体评价、接受解救药物治疗的患者人数以及与镇痛相关的不良反应。
A组不同时间点的VAS评分均显著低于B组（P<0.05）。A组的镇痛需求未满足次数和有效给药次数显著更多，术后12小时和24小时的布托啡诺用量显著更少（P<0.05）。两组的不良事件发生率相似。
对于行腹腔镜结直肠手术的患者，在麻醉诱导时给予40mg帕瑞昔布钠可产生显著的超前镇痛效果。
