Research on the Anesthetic Saftey of Parecoxib and Sufentanil for Patients Undergoing Gastroscopy and Their Effect on Patients’ Satisfaction_West China Medical Journal

Authors：

ZHANG Xiang ,  LIU Bin.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Bin., Email: zhangxiang2000@163.com

Keywords：

无痛胃镜; 帕瑞昔布钠; 舒芬太尼; 满意度

DOI：

10.7507/1002-0179.20130270

Video：

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目的　观察帕瑞昔布钠与舒芬太尼用于无痛胃镜麻醉的安全性和有效性及对患者满意度的影响，为提高临床无痛胃镜麻醉的安全性和舒适性提供依据。方法　采取前瞻性随机双盲对照方法，纳入2011年8月－12月拟行无痛胃镜检查的患者120例，随机分为3组。患者于胃镜检查开始前口服利多卡因胶浆，静脉注射舒芬太尼、帕瑞昔布钠或生理盐水10 mL。检查时静脉注射异丙酚。记录患者检查过程中生命体征、异丙酚使用量、诱导时间、检查时间、苏醒时间、医师以及患者满意度、舒适度等数据。结果　舒芬太尼组检查中各时间点平均动脉压明显低于帕瑞昔布组（P=0.029），血管活性药物用量明显高于帕瑞昔布组（P=0.036）。医师以及患者满意度舒芬太尼组和帕瑞昔布组相当，且均高于对照组（P＜0.05）。除呛咳外，帕瑞昔布组其他不良反应的发生率明显低于舒芬太尼组
（P＜0.05）。结论　实施无痛胃镜检查前15 min静脉注射帕瑞昔布钠0.6 mg/kg或舒芬太尼0.10 μg/kg均可以获得满意的麻醉效果，麻醉医师和患者及家属的满意度明显增高，且帕瑞昔布对呼吸和循环的影响更小，安全性更高。

Citation： ZHANG Xiang,LIU Bin.. Research on the Anesthetic Saftey of Parecoxib and Sufentanil for Patients Undergoing Gastroscopy and Their Effect on Patients’ Satisfaction. West China Medical Journal, 2013, 28(6): 859-863. doi: 10.7507/1002-0179.20130270 Copy

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8.	Noveck RJ, Hubbard RC. Parecoxib sodium, an injectable COX-2-specific inhibitor, dose not affect unfractionated heparin regulated blood coagulation parameters[J]. Journal of Clinical Pharmacology, 2004, 44(5): 474-480.
9.	Barton SF, Langeland FF, Snabes MC, et al. Efficacy and safety of intravenous parecoxib sodium in relieving acute postoperative pain following gynecologic laparotomy surgery[J]. Anesthesiology, 2002, 97(2): 306-314.
10.	程磊, 李斌, 胡惠英, 等. 帕瑞昔布钠超前镇痛对颌面外科手术患者炎性细胞因子和凝血功能的影响[J]. 临床军医杂志, 2011, 39(1): 106-108.
11.	Sachdeva A, Bhalla A, Sood A, et al. The effect of sedation during upper gastrointestinal endoscopy[J]. Saudi J Gastroenterol, 2010, 16(4): 280-284.
12.	黄文东. 芬太尼加丙泊酚用于门诊无痛胃镜的效果观察[J]. 当代医学, 2011, 17(4): 68-69.
13.	刘鲲鹏,廖旭,薛富善. 舒芬太尼的药理学和临床应用[J]. 药物临床研究与应用, 2005, 7(6): 454-457.
14.	Iannuzzi E, Iannuzzi M, Cirillo V, et al. Peri-intubation cardiovascular response during low dose remifentanil or sufentanil administration in association with propofol TCI. A double blind comparison[J]. Minerva Anestesiologica, 2004, 70(3): 109-115.

1. 　王家顺. 无痛胃镜及普通胃镜检查心律失常发生率的比较[J]. 海南医学院学报, 2008, 14(6): 659-662.
2. 　谢昆华, 唐尚伟, 刘源添, 等. 无痛胃镜检查对冠心病患者的安全性探讨[J]. 海南医学, 2011, 22(5): 35-37.
3. 　吴静, 陈德坚. 无痛胃镜检查的不良反应与对策[J]. 实用医技杂志, 2007, 14(3): 323-324.
4. 　Dembo G, Park SB, Kharasch ED. Central nervous system concentrations of cyclooxygenase-2 inhibitors in humans[J]. Anesthesiology, 2005, 102(2): 409-415.
5. 　Reuben SS, Buvanendran A, Kroin JS, et al. Postoperative modulation of central nervous system prostaglandin E2 by cyclooxygenase inhibitors after vascular surgery[J]. Anesthesiology, 2006, 104(3): 411-416.
6. 　王庆, 李真, 王志鹏, 等. 帕瑞者布钠在腹腔镜结肠癌根治术中的超前镇痛作用[J]. 南方医科大学学报, 2010, 30(11): 2556-2557.
7. 　Pavelka K, Recker DP, Verburg KM. Valdecoxib is as effective as diclofenac in the management of rheumatoid arthritis with a lower incidence of gastroduodenal ulcers: results of a 26-week trial[J]. Rheumatology, 2003, 42(10): 1207-1215.
8. 　Noveck RJ, Hubbard RC. Parecoxib sodium, an injectable COX-2-specific inhibitor, dose not affect unfractionated heparin regulated blood coagulation parameters[J]. Journal of Clinical Pharmacology, 2004, 44(5): 474-480.
9. 　Barton SF, Langeland FF, Snabes MC, et al. Efficacy and safety of intravenous parecoxib sodium in relieving acute postoperative pain following gynecologic laparotomy surgery[J]. Anesthesiology, 2002, 97(2): 306-314.
10. 　程磊, 李斌, 胡惠英, 等. 帕瑞昔布钠超前镇痛对颌面外科手术患者炎性细胞因子和凝血功能的影响[J]. 临床军医杂志, 2011, 39(1): 106-108.
11. 　Sachdeva A, Bhalla A, Sood A, et al. The effect of sedation during upper gastrointestinal endoscopy[J]. Saudi J Gastroenterol, 2010, 16(4): 280-284.
12. 　黄文东. 芬太尼加丙泊酚用于门诊无痛胃镜的效果观察[J]. 当代医学, 2011, 17(4): 68-69.
13. 　刘鲲鹏,廖旭,薛富善. 舒芬太尼的药理学和临床应用[J]. 药物临床研究与应用, 2005, 7(6): 454-457.
14. 　Iannuzzi E, Iannuzzi M, Cirillo V, et al. Peri-intubation cardiovascular response during low dose remifentanil or sufentanil administration in association with propofol TCI. A double blind comparison[J]. Minerva Anestesiologica, 2004, 70(3): 109-115.

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Research on the Anesthetic Saftey of Parecoxib and Sufentanil for Patients Undergoing Gastroscopy and Their Effect on Patients’ Satisfaction

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