| Objective: To investigate the effects of preemptive analgesia of parecoxib combined with dezocine therapy to hyperalgesia induced by remifentanil in tibia and fibula fracture ORIF. Methods: 120 patients undergoing open reduction and internal fixation(ORIF) of tibia and fibula fracture were enrolled and randomly divided into 4 groups(n=30). After anesthesia induction, group P, group D, group PD and group C respectively received intravenous parecoxib 40 mg, dezocine 0.1mg/kg, parecoxib 40 mg combined with dezocine 0.1mg/kg and normal saline 5ml 20 minutes before the start of operation. The rest and movement VAS( visual analogue scale) scores were used to assess the intensity of pain at the following time points 1, 2, 4, 12, 24 h(T1-5) after surgery, the MAP, HR and SpO2 were recorded simultaneously.The awaking time, consciousness recovery time, extubation time, SAS score at 10 min after extubation and the incidence of shivering during extubation,PCIA press times and adverse reactions within 24 h after surgery were also recorded and analyzed. Results: There were no significant differences in awaking time, consciousness recovery time, extubation time, the incidence of shivering during extubation, MAP, HR, SpO2, PCIA press times and adverse reactions(P>0.05) among groups. However, the SAS score in group PD was lower than group C(P<0.05). Compared with group C,the rest and movement VAS scores at T1-5 were lower in group P and PD, VAS scores at rest at T1-3 and at movement at T1,5 were lower in group D(P<0.05). Compared with group P, VAS scores at rest and movement at T1,2,4 were decreased in group PD(P<0.05). Compared with group D, VAS scores at rest and movement at T1,2,4 were lower in group PD(P<0.05). Conclusion: Preemptive analgesia of parecoxib combined with dezocine can reduce the postoperative hyperalgesia induced by remifentanil in patients undergoing tibia and fibula fracture ORIF, and the efficacy is better than each used alone. |
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