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武珊珊1,张文杰2▲,王茜1,李佳3,闫佳佳3.塞来昔布联合艾司唑仑超前镇痛在腹腔镜胆囊手术中的应用效果[J].中国医药科学,2024,14(11):159-163        基金项目:
塞来昔布联合艾司唑仑超前镇痛在腹腔镜胆囊手术中的应用效果
Application effect of pre-emptive analgesia with Celecoxib combined with Estazolam in laparoscopic cholecystectomy
  
DOI:
中文关键词:  超前镇痛;腹腔镜胆囊手术;塞来昔布;镇痛效果;血流动力学
英文关键词:Pre-emptive analgesia; Laparoscopic cholecystectomy; Celecoxib; Analgesic effect; Hemodynamics
作者单位
武珊珊1,张文杰2▲,王茜1,李佳3,闫佳佳3 1.广州市番禺区妇幼保健院药剂科,广东广州 511400;2.广州市番禺区妇幼保健院肝胆疝外科,广东广州 511400;3.中山大学附属第一医院药学部,广东广州 510080 
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中文摘要:
      [摘要] 目的 观察塞来昔布联合艾司唑仑超前镇痛在腹腔镜胆囊手术中的应用效果。 方法 选择2021年7月至2022年7月广州市番禺区妇幼保健院收治的腹腔镜胆囊手术患者80例,依据随机数表法分为试验组和对照组,每组各40例。试验组术前给予塞来昔布和艾司唑仑,对照组术前不予处理。比较两组患者术前12 h,术后2、5、10、24、36及48 h的视觉模拟评分法(VAS)评分。两组患者的血流动力学指标和术后首次排气时间、术后至首次下床活动时间、术后首次进食时间、术后住院时间、术前和术后12 h焦虑(SAS)评分、不良反应发生率的发生及术后12、24和36 h吗啡的使用量。 结果 试验组术后5、10、24、36、48 h的VAS评分均低于对照组,差异有统计学意义(P < 0.05)。手术结束时,对照组患者的平均动脉压(MAP)高于试验组、心率(HR)低于试验组,差异有统计学意义(P < 0.05)。两组患者在手术前后的血氧饱和度(SpO2)比较,差异无统计学意义(P > 0.05),手术结束时,试验组、对照组患者MAP均高于麻醉前,HR均低于麻醉前,差异有统计学意义(P < 0.05)。试验组在术后至首次下床活动时间、术后首次进食时间和术后住院时间低于对照组,术后呕吐和头晕发生率低于对照组,术后焦虑SAS评分低于对照组,术后12、24和36 h吗啡的使用量低于对照组,差异有统计学意义(P < 0.05)。 结论 塞来昔布联合艾司唑仑超前镇痛在腹腔镜胆囊手术患者中的应用效果良好,可降低患者围手术期疼痛程度,对患者血流动力学影响更小,术后下床活动更快,住院时间更短,可降低患者术后呕吐和头晕不良反应发生率,改善患者术后焦虑状态,降低术后吗啡的使用量,有助于加速患者康复。
英文摘要:
      [Abstract] Objective To observe the application effect of pre-emptive analgesia with Celecoxib combined with Estazolam in laparoscopic cholecystectomy. Methods A total of 80 patients with laparoscopic gallbladder surgery treated in Panyu Maternal and Child Care Service Centre of Guangzhou from July 2021 to July 2022 were selected and divided into experimental group and control group according to random number table method, with 40 cases in each group. The experimental group was given Celecoxib and Esazolam before surgery, while the control group was not treated before surgery. Visual analogue scale (VAS) scores were compared between the two groups 12 h before surgery and 2, 5, 10, 24, 36 and 48 h after surgery. Hemodynamic indexes, first postoperative exhaust time, first postoperative movement time, first postoperative eating time, postoperative hospital stay, preoperative and postoperative 12 h anxiety (SAS) scores, incidence of adverse reactions, and the use of morphine 12, 24 and 36 h after surgery were measured in both groups. Results VAS scores of experimental groups at 5, 10, 24, 36 and 48 h after surgery were lower than those of control group, and the difference was statistically significant (P < 0.05). At the end of the operation, the mean arterial pressure (MAP) of the control group was higher than that of the experimental group, and the heart rate (HR) was lower than that of the experimental group, with statistical significance (P < 0.05). There was no statistically significant difference in oxyhemoglobin saturation (SpO2) between the two group before and after surgery (P > 0.05). At the end of surgery, MAP and HR in both the test group and the control group were higher than before anesthesia, with statistical significance (P < 0.05). The time from the first time of getting out of bed, the first time of eating after surgery and the time of hospitalization after surgery in the experimental group were lower than those in the control group, the incidence of postoperative vomiting and dizziness, the score of postoperative anxiety SAS, and the use of morphine 12, 24 and 36 h after surgery were lower than those in the control group, with statistical significance (P < 0.05). Conclusion The application effect of pre-emptive analgesia with Celecoxib combined with Estazolam in patients undergoing laparoscopic-assisted gallbladder surgery has a good effect, which can reduce the degree of perioperative pain, have less impact on the hemodynamics of patients, get out of bed faster after operation, and have a shorter hospitalization time. It can reduce the incidence of postoperative vomiting and dizziness, alleviate the anxiety of patients after operation, reduce the amount of morphine used after operation, and conducive to accelerating the rehabilitation of patients.
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