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静脉注射对乙酰氨基酚与帕瑞昔布用于全身麻醉术后镇痛的临床评价

Clinical evaluation of intravenous paracetamol versus Parecoxib for postoperative analgesia after general anaesthesia.

作者信息

Gupta Kumkum, Rastogi Bhawna, Gupta Prashant K, Sharma Deepak, Agarwal Salony, Rastogi Avinash

机构信息

Department of Anaesthesiology and Critical Care, N. S. C. B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.

Department of Radio-diagnosis, Imaging and Interventional Radiology, N. S. C. B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.

出版信息

Anesth Essays Res. 2012 Jan-Jun;6(1):42-6. doi: 10.4103/0259-1162.103372.

Abstract

BACKGROUND

Postoperative pain has a significant impact on patient's recovery and optimal nonopioid analgesia would reduce postoperative pain and pain-related complications. This study was aimed to evaluate the analgesic efficacy and safety of intravenous paracetamol versus parecoxib for postoperative analgesia after surgery.

MATERIALS AND METHODS

Sixty-eight adult consented patients belonging to ASA I and II, scheduled for surgery, were randomly allocated in two treatment groups receiving either infusion of paracetamol (1 gm) or parecoxib (40 mg). The surgical and anesthetic techniques were standardized. Postoperative pain was assessed using visual analog score (VAS) at rest, during coughing and movement. The primary variables were the differences between the mean values of postoperative pain scores, time of first dose of rescue analgesic (tramadol) required, and patient satisfaction throughout the first 12 postoperatively.

RESULTS

There was no significant difference among groups to first request for tramadol. The VAS score was significantly less in parecoxib group at rest compared to paracetamol group (P<0.05), but the same did not differ for pain score while coughing and movement. Patients in the parecoxib group were more satisfied regarding the postoperative pain management at 12 h postoperatively. The incidence of adverse side effects was infrequent in both the groups.

CONCLUSION

Postoperative nonopioid intravenous analgesia with paracetamol and parecoxib is comparable in the early postoperative period with no adverse effects.

摘要

背景

术后疼痛对患者的恢复有重大影响,最佳的非阿片类镇痛可减轻术后疼痛及与疼痛相关的并发症。本研究旨在评估静脉注射对乙酰氨基酚与帕瑞昔布用于术后镇痛的疗效和安全性。

材料与方法

68例年龄≥18岁、美国麻醉医师协会(ASA)分级为Ⅰ或Ⅱ级、拟行手术的成年患者,被随机分为两组,分别接受对乙酰氨基酚(1克)或帕瑞昔布(40毫克)静脉输注。手术和麻醉技术标准化。采用视觉模拟评分法(VAS)评估术后静息、咳嗽及活动时的疼痛情况。主要变量为术后疼痛评分均值的差异、首次需要使用补救镇痛药(曲马多)的时间,以及术后12小时内患者的满意度。

结果

两组患者首次要求使用曲马多的时间无显著差异。静息时,帕瑞昔布组的VAS评分显著低于对乙酰氨基酚组(P<0.05),但咳嗽及活动时的疼痛评分两组无差异。帕瑞昔布组患者对术后12小时的疼痛管理更满意。两组不良反应发生率均较低。

结论

术后早期,对乙酰氨基酚和帕瑞昔布的非阿片类静脉镇痛效果相当,且无不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c70e/4173417/9065c02b4cac/AER-6-42-g002.jpg

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