重庆医学2018，Vol.47Issue(15)：2027-2031,5.DOI:10.3969/j.issn.1671-8348.2018.15.014
COX-2抑制剂在腹腔镜胆囊切除术患者围术期疼痛管理中的应用效果研究
Study on application effect of cyclooxygenase-2 inhibitor in perioperative pain management in patients with laparoscopic cholecystectomy
摘要
Abstract
Objective To investigate the application effect of selective cyclooxygenase-2 (COX-2) inhibitor in perioperative preemptive on-demand analgesia of the patients with laparoscopic cholecystectomy under enhanced recovery after surgery(ERAS).Methods The clinical data in 206 cases of gallstones undergoing selective COX-2 inhibitor for preemptive analgesia (new type analgesic group) from June to December 2015 and 198 cases of gallstones undergoing tramadol postoperative analgesia (traditional analgesia group) in the biliary surgery department of West China Hospital of Sichuan University were retrospectively analyzed.The intraoperative anesthesia schemes in the two groups were consistent.The same pain resolution scheme was adopted after operation.Then the VAS pain score,pain relief drug use rate,adverse reactions,analgesic satisfaction and hospitalization time were compared between the two groups.Results The VAS scores at postoperative 2,6,12,24 h in the new type analgesia group were lower than those in the traditional analgesia group,the difference was statistically significant (P＜0.05);the analgesic drug use rate in the new type analgesia group was lower than that in the traditional analgesia group (14.56％ vs.44.95％,P＜0.05),and the use rate of tramadol hydrochloride and pethidine hydrochloride was lower than that in the traditional analgesia group (P＜0.05).The incidence rate of adverse reactions in the new type analgesia group was lower (2.43％ vs.36.36％,P＜0.05).The incidence rate of nausea and vomiting in the new type analgesia group was lower than that in the traditional analgesia group (P＜0.05),and the incidence rate of other complications had no statistically signifiwas higher than that in the traditional analgesia group (P＜0.05);the average hospital stay and postoperative hospital stay had no statistical difference between the two groups (P＞0.05).Conclusion COX-2 inhibitors can effectively reduce perioperative pain degree in the patients with laparoscopic cholecystectomy,reduces the use frequency of analgesic drugs,shortens the hospital stay time and increases the patient satisfaction.cant difference (P＞0.05).The perioperative patient analgesia satisfaction the in the new type analgesia group关键词
加速康复外科/胆囊切除术,腹腔镜/选择性环氧化酶-2抑制剂/超前镇痛/康复效果Key words
accelerated rehabilitation surgery/cholecystectomy, laparoscopic/selective cyclooxygenase-2 inhibitors/preemptive analgesia/rehabilitation effect分类
医药卫生引用本文复制引用
冯金华,李卡,冯缓,廖永慧,许瑞华..COX-2抑制剂在腹腔镜胆囊切除术患者围术期疼痛管理中的应用效果研究[J].重庆医学,2018,47(15):2027-2031,5.基金项目
四川大学华西医院学科卓越发展1.3.5工程项目(ZY2016204). （ZY2016204）
