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目的探讨帕瑞昔布40 mg术毕前30 min静脉注射(静注)对妇科腹腔镜术后肩痛(PLSP)的影响。方法择期全麻下行妇科腹腔镜手术的患者60例,随机分两组,每组30例。所有患者均予丙泊酚、瑞芬太尼和顺阿曲库铵维持麻醉。术毕前30 min,帕瑞昔布组静注帕瑞昔布40 mg,以氯化钠注射液稀释至5 m L,对照组静注同等容量氯化钠注射液。若术后疼痛难以接受,则予曲马多1 mg·kg-1静注。记录两组术后6、12、24 h的PLSP和腹部伤口疼痛情况,术后24 h内曲马多补救例数及不良反应。结果帕瑞昔布组术后6、12、24 h的PLSP发生率分别为3%、10%、21%,均低于相应时点对照组(29%、71%、39%,P<0.05)。帕瑞昔布组各时点PLSP和腹部伤口疼痛VAS均低于对照组(P<0.05),术后24 h内帕瑞昔布组曲马多补救3例,低于对照组25例(P<0.05),两组均未见不良反应发生。结论帕瑞昔布40 mg术毕前30 min静注可减轻妇科PLSP的发生率和严重程度。
Objective To investigate the effect of intravenous (intravenous) injection of parecoxib 40 mg 30 min prior to gynecologic laparoscopic shoulder pain (PLSP). Methods Sixty patients undergoing gynecological laparoscopic surgery under general anesthesia were randomly divided into two groups of 30 patients. All patients were given propofol, remifentanil and cisatracurium to maintain anesthesia. 30 minutes before surgery, parecoxib 40 mg parecoxib intravenously diluted with sodium chloride injection to 5 m L, the control group intravenous sodium chloride injection of the same volume. If the postoperative pain is difficult to accept, tramadol 1 mg · kg-1 intravenous injection. The PLSP and abdominal wound pain were recorded at 6, 12 and 24 h after operation in both groups, and the number of tramadol remedies and adverse reactions within 24 h after operation were recorded. Results The incidence rates of PLSP in the parecoxib group were 3%, 10% and 21% at 6, 12 and 24 hours after operation, respectively, which were lower than those in the corresponding time point control group (29%, 71%, 39%, P <0.05 ). PLSP and abdominal pain were lower in the parecoxib group than in the control group (P <0.05). Within 24 hours after operation, tramadol was given in 3 cases and was lower than that in the control group (P < 0.05), no adverse reactions occurred in both groups. Conclusion The intravenous injection of parecoxib 40 mg 30 min before surgery can reduce the incidence and severity of gynecologic PLSP.