Bi Ren-bing, Ji Ling, Wang Xiao-kun
Third Department of General Surgery, First Municipal People's Hospital, Jingmen 448000, China.
Email:
Zhonghua Yi Xue Za Zhi. 2013 Sep 10;93(34):2727-9.
To explore the effects of parecoxib sodium multimode analgesia on postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC).
A prospective, double-blind, randomized and placebo-controlled study was conducted on 80 patients undergoing elective LC at Department of Endoscopic Surgery, First Affiliated Hospital, Wenzhou Medical College from March 2011 to June 2011. They were randomized to receive either 40 mg parecoxib infusion 30 min preoperative and at 12, 24, 36, 48 h post-operation (treatment group). And 2 ml normal saline infusion was administered similarly as a placebo (control group). All patients received ropivacaine infusion at port sites at the end of LC. The degree of postoperative pain was assessed with visual analog scale (VAS) at 1, 2, 4, 8, 12, 24, 36, 48 h post-operation respectively. The consumption of pethidine in the first 24 h post-operation was also recorded.
The VAS pain scores at each timepoint were significantly lower in the treatment group than those in the control group (1 h: 1.0 ± 0.6 vs 1.8 ± 0.6, t = -1.650, P = 0.000;2 h: 1.3 ± 0.6 vs 1.9 ± 0.7, t = -4.302, P = 0.000; 4 h: 1.6 ± 0.7 vs 2.7 ± 1.2, t = -4.752, P = 0.000;8 h: 2.5 ± 1.4 vs 5.0 ± 1.8, t = -6.835, P = 0.000; 12 h: 2.2 ± 1.1 vs 3.3 ± 1.5, t = -3.902, P = 0.000; 24 h: 1.6 ± 0.8 vs 2.5 ± 1.4, t = -3.649, P = 0.000; 36 h: 1.2 ± 0.6 vs 2.2 ± 0.8, t = -6.390, P = 0.000; 48 h: 1.0 ± 0.5 vs 1.5 ± 0.6, t = -3.710, P = 0.000). And the amount of pethidine used in the first 24h after LC was also less in the treatment group (150 vs 950 mg, χ(2) = 16.200, P = 0.000).
The infusion multimode analgesia of parecoxib sodium 40 mg provides significant effect of postoperative pain relief after laparoscopic cholecystectomy.
探讨帕瑞昔布钠多模式镇痛对腹腔镜胆囊切除术（LC）患者术后镇痛的效果。
2011年3月至2011年6月，对温州医学院附属第一医院内镜外科80例行择期LC的患者进行前瞻性、双盲、随机、安慰剂对照研究。将患者随机分为两组，治疗组于术前30分钟及术后12、24、36、48小时静脉输注40mg帕瑞昔布；对照组以同样方式输注2ml生理盐水作为安慰剂。所有患者在LC结束时于切口部位输注罗哌卡因。分别于术后1、2、4、8、12、24、36、48小时采用视觉模拟评分法（VAS）评估术后疼痛程度，并记录术后24小时内哌替啶的用量。
治疗组各时间点的VAS疼痛评分均显著低于对照组（1小时：1.0±0.6比1.8±0.6，t=-1.650，P=0.000；2小时：1.3±0.6比1.9±0.7，t=-4.302，P=0.000；4小时：1.6±0.7比2.7±1.2，t=-4.752，P=0.000；8小时：2.5±1.4比5.0±1.8，t=-6.835，P=0.000；12小时：2.2±1.1比3.3±1.5，t=-3.902，P=0.000；24小时：1.6±0.8比2.5±1.4，t=-3.649，P=0.000；36小时：1.2±0.6比2.2±0.8，t=-6.390，P=0.000；48小时：1.0±0.5比1.5±0.6，t=-3.710，P=0.000）。治疗组LC术后24小时内哌替啶用量也少于对照组（150mg比950mg，χ(2)=16.200，P=0.000）。
40mg帕瑞昔布钠静脉输注多模式镇痛对腹腔镜胆囊切除术后疼痛有显著缓解作用。
