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BACKGROUND: The aim of this prospective, randomized, double-blind study was to compare the efficacy of parecoxibfor postoperative analgesia after endoscopic turbinate and sinus surgery, with the non-selective non-steroid anti-inflammatory drug (NSAID), ketorolac. METHODS: A total of 50 patients with an ASA physical status I-II, receiving functional endoscopic sinus surgery (FESS) and endoscopic turbinectomy after local infiltration with 1% mepivacaine, were randomly assigned to receive intravenous administration of either 40 mg parecoxib (N.=25) or 30 mg ketorolac (N.=25), 15 min before the discontinuation of anaesthesia and then every 8 h postoperatively. A blinded observer recorded the incidence and severity of pain upon admission to the postanesthesia care unit (PACU), as well as 10, 20, and 30 min after PACU admission. Thereafter, observations continued every 1 h for the first 6 h, and then 12 h and 24 h after surgery. RESULTS: The area under the curve of the visual analogue scale (AUCVAS) calculated during the study period was 635 (26-1 413) in the Parecoxib group and 669 (28-1 901) in the Ketorolac group (P=0.54). Rescue morphine analgesia was required by 12 patients (48%) in the Parecoxib group and 11 patients (44%) in the Ketorolac group (P<0.05); while mean morphine consumption was 5 +/- 2.5 mg and 5 +/- 2.0 mg in Ketorolac and Parecoxib groups, respectively (P<0.05). No differences in the incidence of side effects were recorded between the two groups. Patient satisfaction was similarly high in both groups, and all patients were discharged uneventfully 24 h after surgery. CONCLUSION: In patients undergoing endoscopic nasal surgery and local infiltration with 1% mepivacaine, parecoxib administered before discontinuing general anesthesia is as effective in treating early postoperative pain as ketorolac. |
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木虫 (正式写手)
- 翻译EPI: 17
- 应助: 13 (小学生)
- 金币: 1897.4
- 散金: 88
- 红花: 8
- 帖子: 446
- 在线: 156.2小时
- 虫号: 1258721
- 注册: 2011-04-08
- 性别: MM
- 专业: 药物分析
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霜叶: 金币+40, 翻译EPI+1, 非常感谢 2013-01-17 15:50:45
霜叶: 金币+40, 翻译EPI+1, 非常感谢 2013-01-17 15:50:45
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背景： 本项前瞻性、随机、双盲研究的目的是比较帕瑞昔布与非选择性非甾体类抗炎药（NSAID）—酮咯酸对于内窥镜鼻甲和鼻窦手术后的的术后镇痛的疗效。 方法： 总共有50例ASA体格状态I-II级患者，在进行1％甲哌卡因局部浸润麻醉后，接受功能性鼻窦内窥镜手术（FESS）及内窥镜鼻甲切除术，麻醉中止前15分钟，被随机分配接受静脉注射40毫克帕瑞昔布（N= 25 ）或30毫克酮咯酸（N= 25），然后术后每8小时进行给药。设盲观察者记录进入麻醉后监测治疗室（PACU）时以及进入PACU后10、20和30分钟的疼痛发生率和严重程度。此后，观察者继续记录，术后前6小时每隔1小时以及在术后12 h和24 h时进行记录。 结果： 在研究期间，计算的帕瑞昔布组视觉模拟评分法（AUCVAS）曲线下面积为635（26-1 413），而酮咯酸组为669（28-1 901）（P = 0.54）。帕瑞昔布组的12例患者（48％），以及酮咯酸组的11例（44％）（P <0.05），要求吗啡进行止痛；而酮咯酸组和帕瑞昔布组的平均吗啡用量分别为5+/-2.5毫克和5+/-2.0毫克（P <0.05）。副作用发生率在两组之间无差异。两组的患者满意度同样高，且所有患者手术后24小时均康复出院。 结论： 在接受鼻内窥镜手术治疗并用1％甲哌卡因局部浸润麻醉的患者，在全身麻醉终止前给予帕瑞昔布，治疗术后早期疼痛，与酮咯酸的疗效相同。 |
2楼2013-01-17 14:25:50