Hsieh Cheng-Yu, Sun Chuan-Hung, Lin Chung-Ching, Chou Yi-Fan
Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan.
School of Medicine, Tzu Chi University, Hualien 970374, Taiwan.
J Clin Med. 2024 Jul 28;13(15):4422. doi: 10.3390/jcm13154422.
Uvulopalatopharyngoplasty (UPPP) is a prevalent surgical procedure for treating obstructive sleep apnea. Effective postoperative pain management is crucial for patient comfort and recovery. This study aimed to compare the analgesic efficacies of parecoxib and ketorolac in patients undergoing UPPP. A prospective, randomized, double-blind study was conducted on 83 patients who received either parecoxib (40 mg intravenously every 12 h) or ketorolac (30 mg intravenously every 8 h) for 2 days following UPPP. Postoperative pain and swallowing discomfort were assessed using visual analog scales (VASs) at 4, 24, 48, and 72 h. The time to resume eating and adverse reactions were also recorded. At 24 and 48 h postoperatively, the mean VAS score was significantly higher in the ketorolac group compared to the parecoxib group (5.0 ± 2.3 vs. 3.6 ± 2.2, = 0.005 and 3.9 ± 2.2 vs. 2.5 ± 1.7, < 0.001, respectively). However, no significant difference in the mean VAS scores was observed between the two groups at 72 h postoperatively. With regards to postoperative swallowing pain, the ketorolac group exhibited significantly higher mean VAS scores than the parecoxib group at 4, 24, 48, and 72 h postoperatively. Intravenous parecoxib may offer superior analgesic benefits in the early postoperative period, particularly in alleviating swallowing pain, compared to ketorolac in UPPP procedures.
悬雍垂腭咽成形术（UPPP）是治疗阻塞性睡眠呼吸暂停的一种常见外科手术。有效的术后疼痛管理对患者的舒适度和康复至关重要。本研究旨在比较帕瑞昔布和酮咯酸在接受UPPP手术患者中的镇痛效果。对83例在UPPP术后接受帕瑞昔布（每12小时静脉注射40毫克）或酮咯酸（每8小时静脉注射30毫克）治疗2天的患者进行了一项前瞻性、随机、双盲研究。在术后4、24、48和72小时，使用视觉模拟量表（VAS）评估术后疼痛和吞咽不适。还记录了恢复进食的时间和不良反应。术后24小时和48小时，酮咯酸组的平均VAS评分显著高于帕瑞昔布组（分别为5.0±2.3对3.6±2.2，P = 0.005；3.9±2.2对2.5±1.7，P < 0.001）。然而，术后72小时两组的平均VAS评分无显著差异。关于术后吞咽疼痛，酮咯酸组在术后4、24、48和72小时的平均VAS评分显著高于帕瑞昔布组。在UPPP手术中，与酮咯酸相比，静脉注射帕瑞昔布在术后早期可能具有更好的镇痛效果，尤其是在减轻吞咽疼痛方面。
