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帕瑞昔布在悬雍垂腭咽成形术后镇痛中的应用。

Application of parecoxib in post-uvulopalatopharyngoplasty analgesia.

作者信息

Xie Guang-Lun, Chu Qin-Jun, Liu Chun-Lan

机构信息

Department of Anaesthesiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China.

出版信息

J Int Med Res. 2013 Oct;41(5):1699-704. doi: 10.1177/0300060513489473. Epub 2013 Aug 9.

Abstract

OBJECTIVE

To investigate the postoperative analgesic effects of parecoxib for uvulopalatopharyngoplasty (UPPP).

METHODS

Patients with obstructive sleep apnoea syndrome who underwent UPPP were randomly divided into two groups. In group A, the incision-local block was performed with 5 ml of 0.5% ropivacaine injected subcutaneously before the end of surgery, then 20 ml of physiological saline was injected intravenously every 12 h for 2 days. In group B, in addition to the incision-local block, 40 mg parecoxib was injected intravenously 30 min before the end of UPPP and 40 mg parecoxib was injected intravenously every 12 h for 2 days. Postoperative pain was measured using a visual analogue scale (VAS). Adverse reactions were recorded.

RESULTS

A total of 40 patients were randomized (n = 20 per group). Under resting conditions, the mean ± SD VAS pain scores were significantly higher in group A compared with group B at 24 h and 48 h after UPPP (24 h 4.0 ± 0.8 versus 2.6 ± 0.6; 48 h 3.8 ± 0.7 versus 2.4 ± 0.5; respectively). Under swallowing conditions, the mean ± SD VAS pain scores were significantly higher in group A compared with group B at 8 h, 24 h and 48 h after UPPP. Postoperative adverse reactions were similar in the two groups.

CONCLUSION

Intravenous parecoxib combined with incision-local ropivacaine provided effective postoperative analgesia for patients with obstructive sleep apnoea syndrome, undergoing UPPP.

摘要

目的

探讨帕瑞昔布对悬雍垂腭咽成形术(UPPP)术后的镇痛效果。

方法

将接受UPPP的阻塞性睡眠呼吸暂停综合征患者随机分为两组。A组在手术结束前皮下注射5 ml 0.5%罗哌卡因行切口局部阻滞,然后每12小时静脉注射20 ml生理盐水,共2天。B组除切口局部阻滞外,在UPPP结束前30分钟静脉注射40 mg帕瑞昔布,术后每12小时静脉注射40 mg帕瑞昔布,共2天。采用视觉模拟评分法(VAS)测量术后疼痛程度,并记录不良反应。

结果

共40例患者被随机分组(每组20例)。在静息状态下,UPPP术后24小时和48小时,A组的平均±标准差VAS疼痛评分显著高于B组(24小时:4.0±0.8 vs 2.6±0.6;48小时:3.8±0.7 vs 2.4±0.5)。在吞咽状态下,UPPP术后8小时、24小时和48小时,A组的平均±标准差VAS疼痛评分显著高于B组。两组术后不良反应相似。

结论

静脉注射帕瑞昔布联合切口局部注射罗哌卡因可为接受UPPP的阻塞性睡眠呼吸暂停综合征患者提供有效的术后镇痛。

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