两种非甾体类抗炎药联合氢吗啡酮在胸腔镜手术患者术后镇痛中的应用：一项随机、双盲、对照临床研究

闫光明; 陈杰; 杨贵英; 段光友; 杜智勇; 余祖滨; 彭静; 廖维; 李洪

doi:10.16016/j.1000-5404.201803125

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两种非甾体类抗炎药联合氢吗啡酮在胸腔镜手术患者术后镇痛中的应用：一项随机、双盲、对照临床研究

临床医学 | 更新时间：2026-01-09

- 两种非甾体类抗炎药联合氢吗啡酮在胸腔镜手术患者术后镇痛中的应用：一项随机、双盲、对照临床研究
- Analgesic effects of 2 nonsteroidal anti-inflammatory drugs respectively combined with hydromorphone in postoperative analgesia after thoracic surgery: a randomized, double blind, controlled clinical study
- 第三军医大学学报 2018年40卷第11期页码：1011-1016
- 作者机构：
- 作者简介：
- 基金信息：
  
  国家自然科学基金面上项目(81571870)
- DOI：10.16016/j.1000-5404.201803125
  中图分类号：
- 收稿：2018-03-16，
  
  纸质出版：2018-06-15
- 稿件说明：
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闫光明, 陈杰, 杨贵英, 等. 两种非甾体类抗炎药联合氢吗啡酮在胸腔镜手术患者术后镇痛中的应用：一项随机、双盲、对照临床研究[J]. 第三军医大学学报, 2018,40(11):1011-1016.

Guangming YAN, Jie CHEN, Guiying YANG, et al. Analgesic effects of 2 nonsteroidal anti-inflammatory drugs respectively combined with hydromorphone in postoperative analgesia after thoracic surgery: a randomized, double blind, controlled clinical study[J]. Journal of Third Military Medical University, 2018, 40(11): 1011-1016.
闫光明, 陈杰, 杨贵英, 等. 两种非甾体类抗炎药联合氢吗啡酮在胸腔镜手术患者术后镇痛中的应用：一项随机、双盲、对照临床研究[J]. 第三军医大学学报, 2018,40(11):1011-1016. DOI： 10.16016/j.1000-5404.201803125.

Guangming YAN, Jie CHEN, Guiying YANG, et al. Analgesic effects of 2 nonsteroidal anti-inflammatory drugs respectively combined with hydromorphone in postoperative analgesia after thoracic surgery: a randomized, double blind, controlled clinical study[J]. Journal of Third Military Medical University, 2018, 40(11): 1011-1016. DOI： 10.16016/j.1000-5404.201803125.

摘要

Abstract

Objective

To compare the postoperative analgesic effects of parecoxib and flurbiprofen axetil combined with hydromorphone respectively on the patients undergoing elective thoracoscopic surgery

and determine the effects on inflammation and postoperative pulmonary complications.

Methods

A total of 156 patients who underwent elective thoracoscopic surgery and then received postoperative patient-controlled intravenous analgesia (PCIA

0.15 mg/kg hydromorphone+0.6 mg ramosetron diluted with saline to 200 mL

infusion speed: 4 mL/h

single PCA dose: 1 mL

and lock time: 15 min) in our hospital from February to November 2017 were prospectively enrolled in this study. They were randomly divided into 3 groups according to the intraoperative analgesic agents they received

that is

40 mg parecoxib sodium (group A)

50 mg flurbiprofen (group B) and 5 mL normal saline (group C)

which were intravenously injected in 30 min before the end of surgery. Numerical rating scale (NRS) of postoperative pain and adverse reactions at 6

48 h after the operation

postoperative pulmonary complications

inflammatory cytokines (C-reaction protein

white cell count

and percentage of neutrophils) and blood gas analysis at 12 h postoperatively and length of hospital stay were recorded and compared between the 2 groups.

Results

Compared with group C

the NRS score was significantly lower in group A and group B at 6 and 12 h after operation (

0.05)

and that of group B was lower than that of group A though no statistical difference (

0.05). The serum C-reaction protein level at 3 d after operation was significantly decreased in groups A and B than group C (

0.05)

and the level of group B was lower than that of group A but there was no significant difference (

0.05). No significant differences were found in the scores of nausea and vomiting and the incidence of postoperative pulmonary complications in the intragroup and intergroup comparison (

0.05). Compared with group C

the mean length of hospitalization was significantly shorter in group B (

0.05)

and there was no significant difference between group A and group C and between group A and group B (

0.05)

though the length was 1.32 d shorter in group B than group A.

Conclusion

Application of both parecoxib sodium or flurbiprofen axetil in 30 min before the end of surgery can enhance the analgesic effect of hydromorphone after thoracoscopic surgery

reduce inflammation and help patients recover after operation. However

flurbiprofen axetil seems to be better than parecoxib sodium.

关键词

Keywords

references

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