摘要
目的观察塞来昔布是否有超前镇痛的作用,同时监测其对围术期细胞因子水平的影响。方法60例骨科下肢择期手术患者,随机分为对照组(A组,安慰剂术前1h口服)、术前镇痛组(B组,塞来昔布200mg术前1h口服)、术后镇痛组Ⅰ(C组,塞来昔布200mg术后即刻口服)、术后镇痛组Ⅱ(D组,塞来昔布200mg术后1h口服)。分别于术后2h、4h、6h、12h、24h、48h进行可视痛觉评分(VAS)测定和观察术后应用曲马多镇痛总量。术前、术毕即刻、术后24小时、术后48小时分别抽取静脉血检测细胞因子IL-1β、IL-2的水平。结果A组VAS在术后各个时点均最高(P<0.05),B组的VAS最低(P<0.05)。术后12h、24h曲马多用量A组用量最大(P<0.01),B组最低(P<0.01)。A组IL-1β水平术后升高的程度最高(P<0.05),余三组没有显著区别(P>0.05)。A组IL-2术后水平下降的程度最高(P<0.01),C、D组次之,B组下降程度最低(P<0.05)。结论下肢手术中塞来昔布(200mg,术前1h)有明显地超前镇痛效果,同时影响围术期机体血清IL-1β和IL-2水平。
Objective To investigate whether celecoxib has the preemptive analgesia effect and its effect to the cytokines IL-1β and IL-2 during analgesia. Methods Sixty orthopedic patients were randomly allocated into one of four equally sized groups. Group A was control group （placebo oral lh preoperative）. Group B was preoperative analgesia group （celecoxib 200mg, oral lh preoperative）. Group C was postoperative pain control group Ⅰ （celecoxib 200mg, oral postoperative immediately）. Group D was postoperative pain control Ⅱ （celecoxib 200mg, oral 1h postoperative ）.The tramadol （100mg intramascular injection postoperative ） was applied if the VAS was still more than or equal to 3 value after the applying of celecoxib. To measure the VAS at 2h, 4h, 6h, 12h, 24h and 48h postoperative, the total dosage of tramadol at 24h and 48h postoperative and the IL-1β,IL-2 level at preoperative and postoperative immediately, 24h and 48h postoperative. Results The VAS of group A were higher than VAS of group B, C and D postoperative （P〈0.05）, the VAS of group B were the lowest among four groups postoperative（P〈0.05）. The total dosage of tramadol applied in group A was the biggest （P〈0.01）and the dosage in group B was the lowest among four groups （P〈0.01） during the 12h and 24h postoperative. The IL-1β level of group A was the highest among four groups postoperative（P〈0.05）. The IL-2 level of group A was the lowest （P〈0.01）and the IL-2 level of group B was the highest （P〈0.05）among all groups postoperative. Conclusion Celecoxib （200mg oral lh preoperative ）has obvious preemptive analgesia effect and modify the IL-1β and IL-2 levels in orthopedic operation.
出处
《中国现代医药杂志》
2008年第1期22-25,共4页
Modern Medicine Journal of China
