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：

無痛胃鏡; 帕瑞昔布鈉; 舒芬太尼; 滿意度

DOI：

10.7507/1002-0179.20130270

Video：

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目的　觀察帕瑞昔布鈉與舒芬太尼用于無痛胃鏡麻醉的安全性和有效性及對患者滿意度的影響，為提高臨床無痛胃鏡麻醉的安全性和舒適性提供依據。方法　采取前瞻性隨機雙盲對照方法，納入2011年8月－12月擬行無痛胃鏡檢查的患者120例，隨機分為3組。患者于胃鏡檢查開始前口服利多卡因膠漿，靜脈注射舒芬太尼、帕瑞昔布鈉或生理鹽水10 mL。檢查時靜脈注射異丙酚。記錄患者檢查過程中生命體征、異丙酚使用量、誘導時間、檢查時間、蘇醒時間、醫師以及患者滿意度、舒適度等數據。結果　舒芬太尼組檢查中各時間點平均動脈壓明顯低于帕瑞昔布組（P=0.029），血管活性藥物用量明顯高于帕瑞昔布組（P=0.036）。醫師以及患者滿意度舒芬太尼組和帕瑞昔布組相當，且均高于對照組（P＜0.05）。除嗆咳外，帕瑞昔布組其他不良反應的發生率明顯低于舒芬太尼組
（P＜0.05）。結論　實施無痛胃鏡檢查前15 min靜脈注射帕瑞昔布鈉0.6 mg/kg或舒芬太尼0.10 μg/kg均可以獲得滿意的麻醉效果，麻醉醫師和患者及家屬的滿意度明顯增高，且帕瑞昔布對呼吸和循環的影響更小，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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2.	謝昆華, 唐尚偉, 劉源添, 等. 無痛胃鏡檢查對冠心病患者的安全性探討[J]. 海南醫學, 2011, 22(5): 35-37.
3.	吳靜, 陳德堅. 無痛胃鏡檢查的不良反應與對策[J]. 實用醫技雜志, 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.	王慶, 李真, 王志鵬, 等. 帕瑞者布鈉在腹腔鏡結腸癌根治術中的超前鎮痛作用[J]. 南方醫科大學學報, 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. 帕瑞昔布鈉超前鎮痛對頜面外科手術患者炎性細胞因子和凝血功能的影響[J]. 臨床軍醫雜志, 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.	黃文東. 芬太尼加丙泊酚用于門診無痛胃鏡的效果觀察[J]. 當代醫學, 2011, 17(4): 68-69.
13.	劉鯤鵬,廖旭,薛富善. 舒芬太尼的藥理學和臨床應用[J]. 藥物臨床研究與應用, 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. 　王家順. 無痛胃鏡及普通胃鏡檢查心律失常發生率的比較[J]. 海南醫學院學報, 2008, 14(6): 659-662.
2. 　謝昆華, 唐尚偉, 劉源添, 等. 無痛胃鏡檢查對冠心病患者的安全性探討[J]. 海南醫學, 2011, 22(5): 35-37.
3. 　吳靜, 陳德堅. 無痛胃鏡檢查的不良反應與對策[J]. 實用醫技雜志, 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. 　王慶, 李真, 王志鵬, 等. 帕瑞者布鈉在腹腔鏡結腸癌根治術中的超前鎮痛作用[J]. 南方醫科大學學報, 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. 帕瑞昔布鈉超前鎮痛對頜面外科手術患者炎性細胞因子和凝血功能的影響[J]. 臨床軍醫雜志, 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. 　黃文東. 芬太尼加丙泊酚用于門診無痛胃鏡的效果觀察[J]. 當代醫學, 2011, 17(4): 68-69.
13. 　劉鯤鵬,廖旭,薛富善. 舒芬太尼的藥理學和臨床應用[J]. 藥物臨床研究與應用, 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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