Haddad Faten, Jaoua Hazem, Mrabet Ali, Bousselmi Jihène, Ben Fadhel Kamel
Tunis Med. 2019 Dec;97(12):1338-1344.
To evaluate the contribution of parecoxib to the protocol of multimodal analgesia for simple vesicular lithiasis by laparoscopy.
A prospective, randomized, double-blind study was carried out at Habib Thameur Hospital (Tunis). We included 60 patients, ASA I or II, scheduled for cholecystectomy by laparoscopy. The patients were randomized to 2 groups. The parecoxib group (PG) receiving parecoxib 40 mg 30 minutes before the induction and the control group (CG) receiving physiological saline. Data were collected during hospitalization and a follow-up was done one year after the operation by a questionnaire.
The pain scores at rest and at cough were significantly lower in the PG than in the CG during the first postoperative day (p < 10-3). Ten percent of the patients of the CG and no patient of the GP required Morphine in the recovery room (p = 0,07). The requirement of Tramadol was significantly less frequent in the PG (70 % of the PG, 16,6 % of the CG and p < 10-3). A chronic pain was found in 37,5 % and 8 %, respectively, in the GC and GP (p = 0,013). This pain was intense in 2 GC patients requiring analgesics and a work stoppage.
The results of our study are in favor of the use of Parecoxib 40 mg 30 minutes before laparoscopic cholecystectomy for its effects on acute pain, opioid sparing and chronic pain.
评估帕瑞昔布对腹腔镜单纯性胆囊结石多模式镇痛方案的作用。
在哈比卜·塔默尔医院（突尼斯）进行了一项前瞻性、随机、双盲研究。我们纳入了60例计划行腹腔镜胆囊切除术的ASA I或II级患者。患者被随机分为2组。帕瑞昔布组（PG）在诱导前30分钟接受40毫克帕瑞昔布，对照组（CG）接受生理盐水。在住院期间收集数据，并在术后一年通过问卷调查进行随访。
术后第一天，PG组静息和咳嗽时的疼痛评分显著低于CG组（p < 10-3）。CG组10%的患者和PG组无患者在恢复室需要吗啡（p = 0.07）。PG组曲马多的使用频率显著较低（PG组为70%，CG组为16.6%，p < 10-3）。GC组和GP组分别有37.5%和8%的患者出现慢性疼痛（p = 0.013）。2例GC组患者的这种疼痛较为剧烈，需要使用镇痛药并导致工作中断。
我们的研究结果支持在腹腔镜胆囊切除术前行30分钟静脉注射40毫克帕瑞昔布，因其对急性疼痛、阿片类药物节省和慢性疼痛有影响。
