帕瑞昔布钠论文：帕瑞昔布超前镇痛对乳腺癌根治术患者心血管反应及术后疼痛的影响.docVIP

帕瑞昔布钠论文：帕瑞昔布超前镇痛对乳腺癌根治术患者心血管反应及术后疼痛的影响 【中文摘要】观察在乳腺癌根治术中,帕瑞昔布钠超前镇痛对心血管反应及术后疼痛的影响。方法：采用随机双盲对照试验设计。ASAⅠ～Ⅱ级择期拟行单侧乳腺改良根治病人50例,随机分成两组：P组(帕瑞昔布)和C组(对照)各25例;两组均采用丙泊酚复合芬太尼静脉全麻,在诱导前10min,P组给予帕瑞昔布40 mg静脉注射作为超前镇痛,C组则给予等量(4 ml)生理盐水。记录入室后静卧5min(T0,基础值)、P组静脉注射帕瑞昔布,C组注射生理盐水后(T1)、手术切皮时(T2)、手术结束时(T3)各时间点的平均动脉压(MAP)、心率(HR)数值,术毕病人恢复情况(苏醒时间、拔管时间、清醒时间)及术后0.5、2、4和24 h疼痛视觉模拟评分(VAS)。结果：与C组比较, P组在T2-T3时间点的MAP、HR数值较C组低(P0.05)；P组在术后0.5、2、4和24 h VAS评分较C组低(P0.05)。P组的高血压的发生几率要明显低于C组；两组病人术毕恢复时间无明显差别。结论：帕瑞昔布纳超前镇痛可产生明显的术后镇痛作用,有效抑制手术刺激诱发的心血管反应,降低术后0.5、2、4和24 h VAS评分,不增加术毕苏醒时间。 【英文摘要】To study the effect of pre-emptive analgesia with Parecoxib on cardiovascular response and the pain after modified radical mastectomy.Methods 50 breast cancer patients with ASA I orⅡundergoing modified radical mastectomy were selected and modified randomly divided into 2 groups:the Parecoxib group (Group P,n=25) and the control group (Group C,n=25)in randomized and double-blind fashion. Anesthesia was induced with propofol and fentanyl.Before induction of anesthesia 10 minutes,parecoxib sodium injection 40 mg was given IV in Group P, equivalent dose of 0.9% NaCl was injected as control in Group C. Mean artery pressure(MAP) and heart rate(HR) were detected at different time points which including times after 5 minutes entering the operation room (TO), immediately injection parecoxib sodium or 0.9% NaCl (T1), at the beginning of operation(T2), and the end of operation (T3).The usa ofvasoactive drugs during perioperative peried, time of awakening,extubation and consciousness were recorded.Visual analog scale(VAS)at 0.5、2、4and24 h after operation were also recorded.Results The concentration of MAP and HR at T2 and T3 were significantly lower than those in the Group C.The VAS pain scores in the Group P were significantly lower than those in the Group C.There are no significant differences in the time of awakening,extubation and consciousness.Conclusion Intravenous Parecoxib may produce pre-emptive effect in modified radical mas