To Observe The Curative Effect Of Parecoxib Combined Dezocine Therapy To Hyperalgesia Induced By Remifentanil

Objective This research is based on hyperalgesia, use parecoxib and dezocine injection to treat hyperalgesia induced by remifentanil, to observe the analgesic effect and the adverse reactions. This research explores the rational drug use in laparoscopic cholecystectomy anesthesia in order to prevent the remifentanil postoperative hyperalgesia, provides the basis for clinical application.Methods80cases of general anesthesia Laparoscopic Cholecystectomy (LC), which were randomly divided into four groups. Group P were given parecoxib sodium40mg15min before surgery; Group D were given dezocine0.1mg/kg15min before surgery finished; Group L were given parecoxib40mg15min before surgery, given dezocine injection0.1mg/kg15min before surgery finished; Group R were not give any analgesic but the remifentanil during surgery. Observe every group the time of eye opening(T1) and extubation(T2), the mean arterial pressure(MAP) and heart rate(HR) at10minutes,30minutes after extubation; the VRS(VAS) pain score at10minutes,20minutes,30minutes,2hours,6hours,12hours after extubation; the incidence of adverse reactions(nausea, vomiting, blood oxygen saturation decreased).Result1.These four groups of patients for age, sex, weight, height were not statistically different.(P>0.05)2.Take repeated measures analysis of variance:2.1.Factors comparison between groups:F=10.375, P<0.001, VAS scores between the groups were statistically significant. (1)the VRS scores of Group D, L, P were significantly lower at each time point than Group R;(2) the VRS score of Group L was lower at each time point than Group D;(3) the VRS score of Group P was lower at each time point than Group D;(4) the VRS score of Group P was lower at10minutes,20minutes,30minutes after surgery than Group L; but the VRS score of Group L was lower at2hours,6hours,12hours after surgery than Group P;(5) the VRS scores of Group D, L, P were significantly lower at each time point than Group RL;2.2.Comparison of the time factor:F=62.9, P<0.001, difference among every time points of groups was statistically significant. Repeated measure effect interacts with treatment effect.the postoperative saturation of blood oxygen of Group RL was significantly lower at each time point than Group D, L, P, R, and the incidence of nausea, vomiting and dizziness of Group RL was significantly higher than other groups.3.D, L, P, R groups were statistically analyzed. Nausea, vomiting, and dizziness of them are not statistically significant. Compared with D, L, P, R groups, postoperative oxygen saturation of the RL group was significantly reduced, and nausea, vomiting, dizziness incidence was significantly higher than other groups.Conclusion1The curative effect of parecoxib combined dezocine therapy to general anesthesia hyperalgesia induced by remifentanil is better than using dezocine only. Compared with using parecoxib alone, the analgesic effect is not as good as using parecoxib within two hours of post-operative, but it is better than using parecoxib two hours after the post-operative; the analgesic effect was better by using them in combination during surgery than using them after surgery. In the same time, it can lower the blood oxygen saturation of patients who is recovering. So the use in combination after surgery is a risk. It should be pay special attention by clinicians. 2The pain of Laparoscopic Cholecystectomy is alleviated6hours after surgery.