帕瑞昔布钠联合头皮神经阻滞用于神经外科开颅术后镇痛的研究

Parecoxib sodium combined scalp nerve block for postoperative analgesia in craniotomy

摘要:

目的：研究帕瑞昔布钠联合头皮神经阻滞对神经外科术后镇痛作用的时间，探讨其是否为一种可行的镇痛方案。方法：60例择期开颅手术病人按数字随机分为2组：头皮神经阻滞组（对照组），帕瑞昔布钠+头皮神经阻滞组（试验组）。麻醉诱导前根据手术切口部位用0.5%的罗哌卡因选择性阻滞眶上神经、耳颞神经、枕大及枕小神经，术毕用0.5%罗哌卡因浸润手术切口。记录拔管后即刻（0时），术后1、2、4、12、24时各时点疼痛评分、镇静评分、恶心呕吐评分、生命体征。结果：帕瑞昔布钠+头皮神经阻滞组镇痛时间可以维持18 h左右，对呼吸、镇静程度及生命体征的影响较小。与对照组相比，延长了追加镇痛药物的时间（P=0.00），但没有改变追加药物的剂量。结论：帕瑞昔布钠联合头皮神经阻滞是一种良好的神经外科术后镇痛方案，值得推广运用。

Abstract:

Objective：To observe the acting time of postoperative analgesic effects after applying Parecoxib sodium combined scalp nerve block and to explore whether scalp nerve block combined with Parecoxib sodium is a good analgesic method for craniotomy. Methods：Totally 60 craniotomy patients were randomly divided into scalp nerve block group（control group） and scalp nerve block combined with Parecoxib sodium group（experimental group）. Based on the location of incision，the supraorbital nerve，auriculotempo－ral nerve，greater occipital and lesser occipital nerve were selectively blocked with 0.5% ropivacaine. In experimental group，Parecoxib sodium was given before surgery. Postoperative pain score，sedation score，nausea and vomiting score，vital signs were recorded at 0，1，2，4，12，24 h postoperatively. Results：In experimental group，the analgesic effect acted for 18 h and exerted slight effect on respi－ratory depression，sedation and vital signs. In control group，Parecoxib sodium combined scalp nerve block extended the rescue anal－gesic time，but did not change the dose used. Conclusion：Parecoxib sodium combined scalp nerve block is a good neurosurgical post－operative analgesia method，which might be widely used.