术前使用帕瑞昔布钠对神经外科手术术后镇痛及凝血功能的影响

发布时间：2018-05-17 16:26

本文选题：帕瑞昔布钠 + 舒芬太尼　；参考：《临床麻醉学杂志》2017年04期

【摘要】：目的观察术前使用帕瑞昔布钠对神经外科手术术后镇痛及凝血功能的影响。方法择期全麻下神经外科开颅患者90例,按照随机数表法,均分为两组:帕瑞昔布组钠(P组)和对照组(C组)。P组在手术开始前30min静脉注射帕瑞昔布钠40mg,C组在手术开始前30min静脉注射生理盐水5ml。两组术后均采用舒芬太尼静脉自控镇痛(PCIA)。PCIA配方为舒芬太尼2μg/kg+托烷司琼0.2mg/kg,加生理盐水至120ml。记录两组患者术后2、4、16、24、48h的VAS评分、Ramsay评分,术后48h内PCIA总按压次数及有效按压次数,于帕瑞昔布钠给药前和给药后2h、48h测定凝血功能,并观察术后不良反应发生情况。结果 C组术后2、4、16、24、48hVAS评分明显高于P组(P0.05),术后2hP组镇静满意率明显高于C组(P0.05)。静脉注射帕瑞昔布钠前和注射2h及48h后,两组各凝血指标差异无统计学意义;术后48h内,C组总不良反应发生率明显高于P组(P0.05)。结论静脉注射帕瑞昔布钠40mg用于神经外科术后镇痛可增强舒芬太尼PCIA的镇痛效应,减少不良反应发生率,同时不影响凝血功能。
[Abstract]:Objective to observe the effect of preoperative use of paroxib sodium on postoperative analgesia and coagulation in neurosurgery. Methods 90 patients with craniotomy under general anesthesia were selected. Both groups were divided into two groups: the control group (group C) and the control group (group C). Group C was treated with 40 mg of paroxib sodium intravenously by 30min before the operation. 30min was injected intravenously with normal saline 5 ml before the operation. Both groups were treated with sufentanil, PCIA, PCIA, sufentanil 2 渭 g/kg, tropisetron 0.2 mg / kg, and normal saline to 120 ml / kg. The VAS scores of the two groups were recorded, the total and effective times of PCIA compression within 48 hours after operation were recorded. The coagulation function was measured before and 2 hours after the administration of paroxib sodium, and the occurrence of postoperative adverse reactions was observed. Results the VAS score of group C was significantly higher than that of group P (P 0.05) at 24 hours after operation, and the satisfaction rate of sedation in group 2hP was significantly higher than that in group C (P 0.05). There was no significant difference in coagulation indexes between the two groups before intravenous injection of paroxib sodium and 2 and 48 hours after injection, and the incidence of total adverse reactions in group C was significantly higher than that in group P within 48 hours. Conclusion intravenous injection of paroxib sodium 40mg can enhance the analgesic effect of sufentanil PCIA, reduce the incidence of adverse reactions, and do not affect the blood coagulation function.
【作者单位】：徐州医科大学江苏省麻醉学重点实验室江苏省麻醉与镇痛应用技术重点实验室;徐州医科大学附属医院麻醉科;
【分类号】：R614

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