[Objective] To observe the analgesic effect of parecoxib sodium combined with fentanyl in patients undergoing chest surgery. [Methods] Forty cases undergoing chest surgery were randomly divided into parecoxib sodium combined with fentanyl group(group P) and fentanyl group(group F) with 20 cases in each.Group P received intravenous parecoxib sodium 40mg and group F received intravenous normal saline(NS) 4ml at 30min before the end of the operation. Patient controlled intravenous analgesia(PCIA) with fentanyl was used for postoperative analgesia in all patients. VAS score and sedation score were recorded at 2h, 4h, 12h and 24h after operation. The total and valid number of pressing of PCA pump, the total consumption of fentanyl and adverse effects were recorded at 24h after operation. [Results] The score of VAS and sedation, fentanyl consumption and the total and valid number of pressing of PCA pump in group P at each time points after operation were significantly lower than those in group F( P ＜0.05). The incidence of nausea, vomiting and somnolence in group P at 24h after operation were less than those in group F( P ＜0.01). [Conclusion] Parecoxib sodium combined with fentanyl for PCIA in patients undergoing chest surgery has better analgesic effect, and can reduce fentanyl consumption and side effects.%[目的]观察帕瑞昔布钠联合芬太尼在胸科手术后的镇痛效果.[方法]选择ASAⅠ～Ⅱ级需行食管癌或贲门癌手术患者40例,随机分成帕瑞昔布钠联合芬太尼(P组)和单纯芬太尼组(F组),每组各20例.于手术结束前30 min,P组静注帕瑞昔布钠40 mg,F组静注生理盐水4 mL.术后均采用芬太尼自控静脉镇痛(PCIA).记录术后2 h、4 h、12 h和24 h两组VAS评分、镇静评分,术后24 h两组PCA按压总次数和有效次数,芬太尼的用量及不良反应.[结果]术后2 h、4 h、12 h和24 h VAS评分,术后24 h PCA按压总次数和有效次数,芬太尼的用量P组均明显少于F组(P<0.05);术后24 h出现恶心、呕吐、嗜睡的患者例数P组也少于F组(P<0.05).[结论]帕瑞昔布钠联合芬太尼用于胸科手术后PCIA镇痛效果更好,能减少术后芬太尼的用量,降低芬太尼所致不良反应的发生率.
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