帕瑞昔布钠复合舒芬太尼对甲状腺手术患者术后镇痛镇静效果、血流动力学及炎症反应的影响

目的:探讨帕瑞昔布钠复合舒芬太尼对甲状腺手术患者术后镇痛镇静效果、血流动力学及炎症反应的影响。方法:选择2018年6月~2019年6月期间100例在我院择期行甲状腺手术患者,根据随机数字表法分为对照组(n=50,术后镇痛予以舒芬太尼)和研究组(n=50,术后镇痛予以帕瑞昔布钠复合舒芬太尼),比较两组患者术后镇痛镇静效果、血流动力学、炎症反应及不良反应。结果:两组患者术后8 h、16 h、24 h视觉疼痛模拟评分(VAS)呈先升高后降低趋势,且研究组低于对照组(P<0.05);两组患者术后8 h、16 h、24 h的Ramsay镇静评分呈先降低后升高趋势,且研究组高于对照组(P<0.05)。对照组患者术后8 h、16 h、24 h心率(HR)、平均动脉压(MAP)呈先降低后升高趋势(P<0.05);研究组术后8 h、16 h、24 h的MAP、HR与术后即刻比较差异无统计学意义(P>0.05);研究组术后8 h、16 h的MAP、HR均高于对照组(P<0.05)。两组患者术后6 h、术后24 h白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)呈先升高后降低趋势,但研究组低于对照组(P<0.05)。两组不良反应发生率比较无统计学差异(P>0.05)。结论:行甲状腺手术的患者术后镇痛予以帕瑞昔布钠复合舒芬太尼,可获得较好的镇痛镇痛效果,能够维持血流动力学平稳,减轻机体炎性反应,且不增加不良反应发生率。

Effects of Parecoxib Sodium Sombined with Sufentanil on Postoperative Analgesia, Sedation Effect, Hemodynamics and Inflammatory Response in Patients Undergoing Thyroid Surgery

Objective: To investigate the effects of parecoxib sodium combined with sufentanil on postoperative analgesia, sedation effect, hemodynamics and inflammatory response in patients undergoing thyroid surgery. Methods: From June 2018 to June 2019,100 patients who underwent elective thyroid surgery in our hospital were selected. The patients were divided into two groups: control group(n=50, sufentanil was given for postoperative analgesia) and the study group(n=50, parexibna combined with sufentanil was given for postoperative analgesia). The effects of postoperative analgesia, sedation, hemodynamics, inflammatory responses and adverse reactions were compared between the two groups. Results: The visual pain analogue scale(VAS) in the two groups at 8 h, 16 h and 24 h after operation increased and then decreased, and that in the study group was lower than that in the control group(P<0.05). The Ramsay sedation scores of the two groups at 8 h, 16 h and 24 h after operation decreased and then increased, and that in the study group was higher than that in the control group(P<0.05). The heart rate(HR) and mean arterial pressure(MAP) of the patients in the control group at 8 h,16 h and 24 h after operation decreased and then increased(P<0.05). There was no significant difference in MAP, HR between 8 h, 16 h and 24 h after operation and immediately after operation in the study group(P>0.05). The MAP and HR in the study group were higher than those in the control group(P<0.05). The levels of interleukin-6(IL-6), C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α)in the two groups at 6 h and 24 h after operation increased and then decreased, however, those in the study group were lower than those in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion: In postoperative analgesia of patients undergoing thyroid surgery, parecoxib sodium combined with sufentanil can obtain better analgesic effect, able to maintain hemodynamic stability, reduce inflammatory reaction of the body, and it do not increase the incidence of adverse reactions.