帕瑞昔布钠超前镇痛对宫腔镜手术患者镇痛效果的影响

Effect of parecoxib sodium preemptive analgesia on analgesic outcomes in hysteroscopic surgery patients

摘要:

目的 探究帕瑞昔布钠超前镇痛在宫腔镜手术中的应用效果及其对疼痛的影响。方法 选取2021年1月—2024年1月宣城市人民医院97例接受宫腔镜手术的患者为研究对象，采用随机数字表法分为对照组（49例）与观察组（48例）。对照组予以常规麻醉，观察组在对照组基础上增加帕瑞昔布钠超前镇痛。比较两组围手术期相关指标［麻醉诱导前（T₀）、麻醉诱导后5 min（T₁）、手术结束时（T₂）的心率、平均动脉压］、手术前后血清学指标［皮质醇（Cor）、血清P物质（SP）、白细胞介素-6（IL-6）、前列腺素E2（PGE2）］的变化、不同时间点的视觉模拟评分法（VAS）评分及安全性。结果 与对照组相比，观察组丙泊酚用量低，Ramsay镇静评分高（P <0.05）；两组T₀、T₁、T₂时的心率、平均动脉压比较：①不同时间点的心率、平均动脉压比较，差异有统计学意义（P <0.05）；②两组的心率、平均动脉压比较，差异有统计学意义（P <0.05）；③两组的心率、平均动脉压变化趋势比较，差异有统计学意义（P <0.05）。观察组手术前后Cor、SP、IL-6和PGE2水平的差值低于对照组（P <0.05）。两组术后6、12、24 h VAS评分比较：①不同时间点VAS评分比较，差异有统计学意义（P <0.05）；②两组VAS评分比较，差异有统计学意义（P <0.05），实验组VAS评分较对照组低，相对镇痛效果较好；③两组VAS评分变化趋势比较，差异有统计学意义（P <0.05）。对照组与观察组不良反应总发生率比较，差异无统计学意义（P >0.05）。结论 对行宫腔镜手术患者予以帕瑞昔布钠超前镇痛可有效减轻疼痛，减轻炎症及应激反应，维持血流动力学稳定，且用药安全。

Abstract:

Objective To evaluate the efficacy of parecoxib sodium preemptive analgesia in patients undergoing hysteroscopic surgery.Methods Ninety-seven patients scheduled for hysteroscopy (January 2021 - January 2024) were randomized to control (n = 49) or observation (n = 48) groups. Both received routine anesthesia; the observation group additionally received preemptive parecoxib sodium. Outcomes included: Perioperative indicators [heart rate (HR), mean arterial pressure (MAP) at baseline (T₀), 5 min post-induction (T₁), and surgery end (T₂)]; Serum biomarker changes (cortisol [Cor], substance P [SP], interleukin-6 [IL-6], prostaglandin E2 [PGE2]); Visual Analog Scale (VAS) scores at 6, 12, and 24 h postoperatively; and Safety.Results The observation group required less propofol and achieved higher Ramsay sedation scores (P < 0.05). Significant differences were observed in HR and MAP: Across timepoints (P < 0.05); Between groups (P < 0.05); and In group-time interactions (P < 0.05). Postoperative decreases in serum Cor, SP, IL-6, and PGE2 were greater in the observation group (P < 0.05). VAS scores demonstrated: Time effects (P < 0.05); Intergroup differences (observation group < control, P < 0.05); and Group-time interactions (P < 0.05). Adverse event rates did not differ significantly (P > 0.05).Conclusion Preemptive parecoxib sodium effectively reduces postoperative pain, attenuates inflammatory/stress responses, maintains hemodynamic stability, and demonstrates favorable safety in hysteroscopic surgery.