| OSAHS patients have difficulty in breathing and respiratory depressionpossibility, the incidence of postoperative respiratory depression largely depends onthe analgesic effect.Generally，opiate drug increased respiratory depression on thebasis of labor pains，this raised new problems for clinical anesthesia. opium kindanalgesics have no anti-inflammatory effect， which the best alternative andsupplementary is non-steroidal anti-inflammatory drugs.Non-steroidalanti-inflammatory drugs make the risk of bleeding increasely and disabled forpatients generally，but UPPP operation requirements highly on the coagulationsystem and labor pains in anesthesia recovery period，restlessness during recoverycould result in failed back surgery，Parecoxib is the first intravenous or intramuscularinjection of selective cyclooxygenase-2inhibitors and better effect onexercise-induced pain.To overcome the previous non-selective COX inhibitors onblood clotting and the adverse reaction, with music PCIA postoperative analgesiahorses, a preoperative, intraoperative and postoperative analgesia pattern purpose, byreducing the song to reduce the dosage of horses side effects occur. Can be used forOSAHS patients, have anti-inflammatory and analgesic effects and OSAHS patientsfor clinical analgesic provides new options.Objective: To observe the degree of restlessness during recovery and paintherapy effect of parecoxib sodium on OSAHS patients undergoing UPPP.Methods: Select60OSAHS patients who got UPPP with ASA grade II-III,age20-65years old, were scheduled for selective operation，according to hypopneaindex and blood oxygen saturation sure OSAHS patient jams grading light, moderate patients after drawing tube and hand the normal income statistics. Randomly dividedinto A B two groups: group A were given saline2ml20minutes before surgery andat the end of the operation，the patients in group B injected parecoxib sodium40mgat the same time, they all use general anesthesia with propofol and remifentanil,allpatients received intravenous injection tramadol through PCI when propofol andremifentanil deactivated. Record preoperative and postoperative heart rate, bloodpressure. Observed two groups of fentanyl and remifentanil amount and came withthe period after recovering consciousness time and RASS, after2h,4h,6h,12h,24hVAS score, record12h,24h PCIA pump manual press numbers, the calculation of12h, within24h pump song horses in analgesia consumption and adverse reactionrate. Record the postoperative within24satisfaction.The result: There was no statistic difference between the A and B groups inthe blood pressure and heart rate when awareness period and postoperative6,12h,intraoperative remifentanil and fentanyl dosage in group B were significantly lessthan group A. There was no statistic difference between the two groups inconsciousness recovery time and with tube time.Compared with two groups Rasspoints,the moderate and severe cases in group B was significantly more than those ingroup Awere significantly..The VAS points of group B was significantly lower at2h,4h,12h than that in group B after operation. Manually the number of analgesiapump, dosage of tramadol in the analgesia pump and incidence of adversereactions,which in group B was significantly lower at24hours after surgery thanthat in group A,satisfaction for PCA cure, group B is better than group A.Conclusion: Parecoxib sodium on patients of OSAHS with acute pain hasgood effect because of UPPP, it can relieve hyperalgesia becaused of remifentaniland reduce the amount of opiate drug and restlessness during recovery. but also hasthe effect of advance labor pains, as adjuvants, enhances postoperative analgesiaeffect with tramadol PCIA multimodal analgesia, reduce the dosage and side effects of tramadol, does not influence the coagulation system and not increasegastrointestinal side effects. It play a central and peripheral double antiinflammatoryand analgesic effects at preoperatively, extubation and postoperative. It provides anew choice for OSAHS patients in clinical analgesic. |
PDF Full Text Request