Objective To compare the effects of parecoxib sodium, tramadol and fentanyl in multimodal analgesia. Methods Ninety adult patients suffering from open thoracotomy were randomized into three groups referred as A,B and C.They received intravenously tramadol 1 mg/kg (group A),fentanyl 1 μg/kg (group B),and parecoxib sodium 40 mg(group C),according to patient controlled analgesia loading dose when skin was sutured with PCIA stared. The analgesic effect was observed by VAS at 1,2,3,4,5,6h after injection. Record the side effect rate during waking up period after general anesthesia. Results Analgestic effect in group C was obviously better than that in the other two groups; side effect rate in group C was significantly lower than that in group A and group B. Conclusion Parecoxib sodium is suitable for patient controlled analgesia loading dose after operation.%目的 比较帕瑞昔布钠、曲马多和芬太尼在多模式镇痛中的应用效果.方法 选取医院胸外科开胸手术患者90例,随机分为A,B,C 3组.在手术缝合皮肤时分别静脉给予患者自控镇痛负荷剂量,A组给予曲马多1 mg/kg,B组给予芬太尼1μg/kg,C组给予帕瑞昔布钠40mg,启动镇痛泵.评估给药后1,2,3,4,5,6 h时患者疼痛状况,疼痛评估采用视觉模拟评分(VAS);记录患者全身麻醉苏醒期发生不艮反应的例数,统计其发生率.结果 C组明显比A组和B组的镇痛时间长,镇痛效果好,B组略优于A组(P<0.05);不良反应发生率C组明显比A组和B组低,拔管平稳.结论 帕瑞昔布钠可作为术后患者自控镇痛负荷剂量的理想用药.
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