对下肢骨折手术患者围术期不同时间段应用依托考昔术后镇痛效果的评估

doi:10.16260/j.cnki.1009-2188.2017.05.012

中国现代手术学杂志

2017, Vol. 21

Issue (5): 371-375 DOI: 10.16260/j.cnki.1009-2188.2017.05.012

临床论著

对下肢骨折手术患者围术期不同时间段应用依托考昔术后镇痛效果的评估

谢志进1，方跃2

1.成都市第七人民医院骨科，成都 610041； 2.四川大学华西医院骨科，成都 610041

The Analgesic Effects of Different Modes of Etoricoxib Analgesia for Postoperative Patients with Lower Limb Fractures

XIE Zhi-jin1, FANG Yue2

1.Department of Orthopedics, the Seventh People's Hospital of Chengdu, Chengdu 610041, Sichuan, China; 2.Department of Orthopedics, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China

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摘要目的评估在下肢骨折手术围术期镇痛中不同时间段应用依托考昔的镇痛效果。方法选择2012年3月至2016年9月在成都市第七人民医院骨科住院进行下肢骨折切开复位内固定手术治疗的患者90例，随机分为依托考昔术前3d预防性镇痛组（A组）、依托考昔手术日术前2 h预防性镇痛组（B组）、依托考昔术毕麻醉清醒后2h镇痛组（C组），每组30例。记录术后多个时间点的疼痛数字分级法评分（numeric rating scales，NRS）及术后补救镇痛药物哌替啶注射液的用量，观察并记录不良反应发生情况。结果A、B两组在术后4 h、8 h、12 h、24 h时的NRS评分，及补救镇痛药物24 h使用量方面均优于C组，A、B两组分别与C组比较其差异均具有统计学意义（P﹤0.05），而A、B两组之间的比较其差异则不具有统计学意义（P＞0.05）。三组间高血压（χ2=2.070, P=0.355）及肝肾功能异常（χ2=1.041, P=0.594）的发生率均不存在差异。结论术前3 d和术前2 h依托考昔在下肢骨折围术期镇痛中均具有明显的预防性镇痛作用，但术前3 d开始口服并不比术前2 h开始口服更具有显著优势。

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	XIE Zhi-jin1
	FANG Yue2

关键词: 镇痛 COX-2抑制剂依托考昔下肢骨折

Abstract: ObjectiveTo assess the effects of perioperative analgesia of a selective cyclooxygenase 2 inhibitor(COX2),etoricoxib, on pain managements.MethodsA total of 90 patients with lower limb fractures, who admitted to the Department of Orthopedics, the Seventh People's Hospital of Chengdu, from March 2012 to September 2016, were randomly divided into three groups. Group A received etoricoxib 3 days before the surgery. Group B received etoricoxib 2 hours before the surgery on the operation day. Group C received etoricoxib 2 hours after the recovery from anesthesia. Numeric rating scales (NRS) were recorded after the operation. The adverse drug reaction, and the total dosages of pethidine for remedial analgesia after surgery were also recorded.ResultsCompared with Group C, the patients with preemptive analgesia groups (Group A and B)had significantly lower NRS scores at 4h、8h、12h and 24h after the operation(P<0.05), but there was no statistical significance between Group A and B(P>0.05). The consumption of pethidine had no difference between Group A and B either(P>0.05).ConclusionEtoricoxib has a preventive analgesia effect in perioperative analgesia, but there is no significant advantage of the 3day preoperative oral etoricoxib adoption comparing with the 2hour preoperative one.

Key words: analgesia cyclooxygenase2 inhibitor etoricoxib lower limbs fractures

出版日期: 2017-10-26 发布日期: 2018-05-25 期的出版日期: 2017-10-26

ZTFLH:	R683.42
	R97

基金资助: 四川省卫生和计划生育委员会科研课题（编号150013）

作者简介: 谢志进，男，42岁，成都市第七人民医院骨科副主任医师。

引用本文:

谢志进1，方跃2. 对下肢骨折手术患者围术期不同时间段应用依托考昔术后镇痛效果的评估[J]. 中国现代手术学杂志, 2017, 21(5): 371-375.
XIE Zhi-jin1, FANG Yue2. The Analgesic Effects of Different Modes of Etoricoxib Analgesia for Postoperative Patients with Lower Limb Fractures. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 371-375.

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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2017.05.012 或 http://www.surgerychina.com/CN/Y2017/V21/I5/371

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