帕瑞昔布钠联合右美托咪定对甲状腺术患者术后苏醒及疼痛的影响-现代医学

帕瑞昔布钠联合右美托咪定对甲状腺术患者术后苏醒及疼痛的影响

单位：1. 海南省妇幼保健院麻醉科, 海南海口 570206;
2. 海口市第四人民医院麻醉科, 海南海口 571100;
3. 海南医学院第一附属医院麻醉科, 海南海口 570000

分类号：R581;R614.3

出版年·卷·期（页码）：2019·47·第八期（946-950）

摘要：

目的：探讨帕瑞昔布钠联合右美托咪定对甲状腺术患者术后苏醒及疼痛的影响。方法：选取我院甲乳外科接受甲状腺手术治疗的患者142例，按随机数字表法分组，对照组71例术前予以右美托咪定治疗，研究组71例在对照组基础上予以帕瑞昔布钠。比较两组间苏醒质量相关指标、血流动力学指标水平、血清P物质（SP）及炎性细胞因子水平，同时比较苏醒期并发症及药物不良反应发生率。结果：与对照组比较，研究组术后拔管时间、苏醒时间较短，Riker镇静躁动评分量表（SAS）评分、疼痛视觉模拟评分法（VAS）评分较低，拔管后5 min收缩压（SBP）、舒张压（DBP）及心率（HR）水平及麻醉前后差值较低，手术后血清SP、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平及手术前后差值较低，具有统计学意义（P<0.05）；手术后，研究组苏醒期躁动及拔管呛咳的发生率明显低于对照组，具有统计学意义（P<0.05）；研究组恶心呕吐、嗜睡及呼吸抑制的发生率与对照组比较，无统计学差异（P>0.05）。结论：帕瑞昔布钠联合右美托咪定能缩短甲状腺手术患者拔管时间及苏醒时间，控制血流动力学指标波动，减少苏醒期并发症，提高术后苏醒质量，降低血清SP、TNF-α、IL-6水平，减轻术后疼痛，药物镇静镇痛作用安全有效。

Objective:To investigate the effects of pareoxib sodium combined with dexmedetomidine on postoperative recovery and pain in patients with thyroid surgery.Methods:A total of 142 patients undergoing thyroid surgery from the Department of Thyroid and Breast Surgery in our hospital were selected and grouped by random number table method, 71 cases in the control group additionally received dexmedetomidine before operation, 71 cases in the experiment group received parecoxib sodium on top dexmedetomidine. Awakening quality related indexes, hemodynamic indexes levels, serum P substance (SP) and inflammatory cytokine levels, and the incidence of complications in the awakening period and adverse drug reactions were compared after the treatment. Results:Compared with the control group, the time of postoperative extubation and the awakening time were shorter, and the Riker sedative restlessness scale (SAS) score and the pain visual analogue scale (VAS) score were lower after operation in the experiment group, the levels of systolic pressure (SBP), diastolic pressure (DBP) and heart rate (HR) at 5min after extubation and the difference -value before and after anesthesia were lower, the levels of serum SP, tumor necrosis factor -α (TNF-α) and interleukin -6 (IL-6) after operation and the difference -value before and after operation were lower, with a significant difference (P<0.05); after the operation, the incidence of restlessness during the awakening period, extubation and choking cough in the experiment group was significantly lower than that of the control group, with a significant difference (P<0.05); the incidence of nausea and vomiting, somnolence and respiratory depression in the experiment group was not significantly different compared with the control group (P>0.05).Conclusion:Pareoxib sodium combined with dexmedetomidine can shorten the time of extubation and the awakening time of patients with thyroid surgery, control the fluctuation of hemodynamic indexes, reduce the complications of awakening, improve the quality of recovery after operation, reduce the levels of serum SP, TNF-α and IL-6, relieve postoperative pain, and the sedative and analgesic effect of the drug is safe and effective.

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