摘要
目的:观察术前服用塞来昔布对局麻下翼状胬肉切除联合羊膜移植术患者术后疼痛的影响。方法:选择72例因单眼翼状胬肉需行胬肉切除联合羊膜移植的成年患者,随机分为术前和术后两组。术前组(n=36)在术前30min服用塞来昔布200mg,术后服用维生素E200mg;术后组(n=36)服药顺序相反。视觉模拟评分(VAS)≥5分患者,予盐酸哌替啶50mg肌肉注射。分别记录术后4、8、12h和24h时点的VAS评分和患者对镇痛的总体满意度等指标。结果:在术后8h,术前组有较低的VAS评分(1.8±0.1vs.2.9±0.3,P<0.05)和较低的镇痛效果欠佳(VAS≥3)比例(19.4%vs.36.1%,P<0.05),而两组间在其余时点镇痛评分相似。术后组有3例患者需要盐酸哌替啶补救镇痛。术后组有2例呕吐,均为盐酸哌替啶镇痛患者。术前组患者的镇痛总体满意度高于术后组(87%vs.62%,P<0.05)。结论:术前服用塞来昔布可有效地缓解翼状胬肉切除联合羊膜移植术后疼痛。
Objective To investigate clinical effects of pre-operative celebrex administration on post- operative pain management in patients undergoing primary pterygium excision and amniotic membrane transplantation under local anesthesia. Methods Seventy-two patients undergoing selective primary pterygium excision and amniotic membrane transplantation under local anesthesia were assigned randomly to pre-op and post-op groups. Patients in pre-op group （n = 36） received a pill of celebrex 200 mg pre-operatively and a pill of vitamin E 200 mg post-operatively, whereas patients in post-op group （n = 36） took pre-operative vitamin E and post-operative celebrex at the exact dosage. Visual analog score （VAS） was monitored at 4, 8, 12 and 24 h post-operatively. A pethidine dose of 50 mg was prescribed intra-muscularly on patients＇ demand or when the VAS reached or exceeded 5. Results The VASs and ratios of VAS≥3 were similar between the groups except that at 8 h time-point the pre- op patients had a lower VAS （ 1.8±0.1 vs. 2.9±0.3, P 〈 0.05） and lower ratio of VAS≥3 （ 19.4% vs. 36.1%, P 〈 0.05）. Three patients in post-op group but none in pre-op group required pethidine analgesia rescue. There were 2 vomiting cases because of rescue analgesics. The over-all satisfactory with analgesia was higher in pre-op group than post-op group （87% vs. 62% ;P 〈 0.05）. Conclusions A celebrex dose of 200 mg administrated pre-operatively may provide more beneficial effects in reducing early surgical pain and improving patients＇ satisfaction when compared with post-operative administration.
出处
《实用医学杂志》
CAS
北大核心
2012年第16期2783-2785,共3页
The Journal of Practical Medicine
