塞来昔布联合普瑞巴林预先给药对老年骨科患者术后疼痛的影响

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (9): 1039-1043.

塞来昔布联合普瑞巴林预先给药对老年骨科患者术后疼痛的影响

张昌锋, 郑羡河, 胡双燕, 陈念平, 李玉红

绍兴市人民医院/浙江大学绍兴医院麻醉科,绍兴 312000,浙江

收稿日期:2013-03-16 修回日期:2013-05-21 发布日期:2013-09-07
通讯作者: 郑羡河,男,本科,主任医师,研究方向:临床麻醉。Tel: 13575543446 E-mail: zxh1217@163.com
作者简介:张昌锋,本科,主治医师,研究方向:临床麻醉。Tel: 13858461031 E-mail: 969992141@qq.com

Effects of premedication with celecoxib and pregabalin on postoperative pain in the elderly orthopedic patients

ZHANG Chang-feng, ZHENG Xian-he, HU Shuang-yan, CHEN Nian-ping, LI Yu-hong

Department of Anesthesiology, Shaoxing People's Hospital/Zhejiang University Shaoxing Hospital, Zhejiang Province, Shaoxing 312000, Zhejiang, China

Received:2013-03-16 Revised:2013-05-21 Published:2013-09-07

摘要/Abstract

摘要： 目的: 观察塞来昔布联合普瑞巴林预先给药用于老年骨科患者的安全性,及对术后疼痛的影响。方法: 择期行股骨头或全髋关节置换术的老年病人100例, ASAⅠ～Ⅱ级,随机分为4组(n=25):安慰剂对照组(C组)、塞来昔布组(S组,200 mg)、普瑞巴林组(P组,300 mg)、塞来昔布和普瑞巴林联合用药组(L组,塞来昔布 200 mg 和普瑞巴林 150 mg)。记录术毕苏醒时间、术后2、4、6、8、12、24 h 的体动视觉模拟疼痛评分(VAS)和Ramsay镇静评分,以及术后 72 h 内芬太尼和曲马多的总用量,以及头晕、嗜睡、恶心呕吐等不良反应的发生率。结果: 体动VAS评分:术后2、4、6、8 h C组高于同时间点其他组,术后8、12 h L组低于同时间点其他组(P<0.05)。Ramsay评分:术后2、4、6 h P组高于同时间点其他组,术后2、4 h L组高于同时间点C组和S组(P<0.05)。与P组比较,C组、S组和L组苏醒时间更短(P<0.05);与C组比较,术后 72 h 内S组、P组和L组的芬太尼和曲马多用量减少(P<0.05);与L组比较,S组和P组芬太尼和曲马多用量增加(P<0.05);与P组比较,C组、S组和L组术后不良反应发生率明显降低,差异有统计学意义(P<0.05)。结论: 塞来昔布联合普瑞巴林预先给药可安全用于老年骨科患者,且能明显减轻术后疼痛。

关键词: 塞来昔布, 普瑞巴林, 超前镇痛, 老年人

Abstract: AIM: To observe the safety and effect on postoperative pain of premedication with celecoxib and pregabalin in the elderly orthopedic patients.METHODS: One hundred ASA ⅠorⅡelderly patients aged 68-84 year and weighing 52-64 kg undergoing elective operation on the femoral head or hip joint were randomly divided into 4 groups(n=30 each):control group(group C), celecoxib group(group S), pregabalin group(group P) and combination group(group L). Celecoxib 200 mg was taken in group S, pregabalin 300 mg was taken in group P, celecoxib 200 mg and pregabalin 150 mg were taken in group L before operation 1 h, while in group C placebo was taken. Patient-controlled intravenous analgesia with fentanyl and tramadol was used in all patients in 72 h after operation. If VAS score was more than 3, a bolus of fentanyl 0.2 μg/kg was given i.v.. And then the recovery time, moving VAS score and Ramsay score at 2,4,6,8,12,24 h postoperation, and total amount of fentanyl and tramadol in 72 h postoperation, and the incidence of adverse reaction included dizzy, lethargy, nausea and vomiting were recorded.RESULTS: Moving VAS score in group C at 2,4,6,8 h postoperation was higher than in other groups at the same time,while the score in group L at 8,12 h postoperation was lower.Ramsay score in group P at 2,4,6 h postoperation was higher than that in other groups at the same time,while the score in group L at 2,4 h postoperation was higher than that in group C and S. Compared with group P, the recovery time was shorter in group C, S and L.Compared with group C, the total amount of fentanyl and tramadol consumed in 72 h postoperation was smaller in group S, P and L. Compared with group L, the total amount of fentanyl and tramadol consumed was bigger in group S and P. Compared with group P, the incidence of adverse reaction was lower in group C, S and L (P<0.05).CONCLUSION: Celecoxib combined with pregabalin pretreatment can be used safely in elderly orthopedic patients, and can significantly reduce postoperative pain.

Key words: Celecoxib, Pregabalin, Preemptive analgesia, Aged

中图分类号:

R614

张昌锋, 郑羡河, 胡双燕, 陈念平, 李玉红. 塞来昔布联合普瑞巴林预先给药对老年骨科患者术后疼痛的影响[J]. 中国临床药理学与治疗学, 2013, 18(9): 1039-1043.

ZHANG Chang-feng, ZHENG Xian-he, HU Shuang-yan, CHEN Nian-ping, LI Yu-hong. Effects of premedication with celecoxib and pregabalin on postoperative pain in the elderly orthopedic patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(9): 1039-1043.

[1]	叶红波, 宋洋洋, 薛领, 芮建中. 基于模型的Meta分析建立中国老年人群美罗培南群体药动学模型[J]. 中国临床药理学与治疗学, 2022, 27(9): 984-990.
[2]	徐永霞, 谢明珠, 宫牧雪, 黄嘉莹, 赵丽, 朱德发. 25羟维生素D对老年2型糖尿病患者胰岛β细胞功能的影响[J]. 中国临床药理学与治疗学, 2020, 25(9): 1021-1026.
[3]	杨明, 董晓雯, 洪华山. 他汀在75岁及以上老人进行心血管疾病一级预防的现状[J]. 中国临床药理学与治疗学, 2020, 25(9): 1074-1080.
[4]	潘战和, 王馨, 苏安, 张鹏, 纪浩南, 王小梅. 基于Notch 1/NF-κB/STAT3通路探讨塞来昔布逆转NK/T细胞淋巴瘤细胞阿霉素耐药的作用机制[J]. 中国临床药理学与治疗学, 2020, 25(12): 1330-1336.
[5]	阮仁杰，刘茜茜，金华丹，王崇敏. 普瑞巴林联合氦氖激光理疗对带状疱疹后遗神经痛患者疼痛及睡眠质量的影响[J]. 中国临床药理学与治疗学, 2017, 22(7): 795-798.
[6]	何建国，袁立勇，陈林，姜娟. 帕瑞昔布钠在小儿腹腔镜阑尾切除术中的超前镇痛作用[J]. 中国临床药理学与治疗学, 2017, 22(6): 705-708.
[7]	常永丽，许银红，温雪敏，郭桢楠，张丽慧，韩颖，郭晓姝. 地佐辛复合酮咯酸氨丁三醇超前镇痛对大鼠术后痛阈和炎性反应的影响[J]. 中国临床药理学与治疗学, 2017, 22(3): 267-271.
[8]	朱波，王寿根，张自强，陈蕾，马佳燕. 不同剂量右美托咪啶复合表面麻醉用于老年术中高血压患者白内障手术的效果[J]. 中国临床药理学与治疗学, 2016, 21(9): 1050-1054.
[9]	王瑜，仲云熙，金孝亮，谷世寅，彭英，尹莉芳，贾元威，孙建国，王广基. 高效液相色谱-串联质谱法测定犬血浆中的普瑞巴林及在药代动力学中的应用[J]. 中国临床药理学与治疗学, 2016, 21(7): 731-738.
[10]	李运曼, Kodithuwakku Nandani Darshika, 方伟蓉. 比阿培南在老年患者中的合理应用及疗效评价[J]. 中国临床药理学与治疗学, 2015, 20(1): 43-46.
[11]	项小兵, 连燕虹, 吴盈利, 袁晓红, 柳兆芳. 不同呼末浓度七氟醚对老年患者顺式阿曲库铵肌松效应的影响[J]. 中国临床药理学与治疗学, 2014, 19(9): 1033-1036.
[12]	罗雪梅, 严思敏, 葛卫红. 硬膜外麻醉与腰-硬联合麻醉用于老年股骨头置换术的系统评价[J]. 中国临床药理学与治疗学, 2014, 19(8): 890-897.
[13]	崔涛, 高晶, 伊秀林, 曾勇, 李薇, 司端运. 塞来昔布胶囊犬口服给药的体内过程及一致性评价[J]. 中国临床药理学与治疗学, 2013, 18(4): 371-375.
[14]	杜坚宗, 刘小利, 赵恬, 顾亮, 钦光跃. 23价肺炎球菌多糖疫苗和流行性感冒疫苗防治老年慢性肺病急性发作的研究[J]. 中国临床药理学与治疗学, 2012, 17(6): 700-702.
[15]	戴平, 黄燕丽, 路牧, 蔡栋江, 郦正阳. 普瑞巴林与加巴喷丁用于腹式子宫切除术后疼痛治疗的效果比较[J]. 中国临床药理学与治疗学, 2012, 17(1): 92-96.