Clinical Study of Multi－analgesic for Postoperative Analgesiaon Patients Undergoing Endonasal Transsphenoidal for Saddle Area Placeholder
|School||Chongqing Medical University|
|Keywords||Cyclooxygenase inhibitors pain postoperative Analgesia|
Objective To evaluat the postoperative pain degree of patientsundergoing endonasal transsphenoidal approach for sellar resection. Toevaluate postoperative analgesic efficacy and safety of intravenousinjection Parecoxib， Ropivacaine local infiltration anesthesia and Multi－analgesic on endonasal transsphenoidal local mass resection saddle areain postoperative period.Methods This was a prospective, randomized, double－blind, Place－controlled study.80patients undergoing endonasal transsphenoidalapproach for sellar resection were randomly divided into4groups （n=20each）： group S （Saline）,group P （Parecoxib Sodium）,group L（Ropivacaine）,group P+L（Parecoxib Sodium ad Ropivacaine）.Group Sreceived10ml normal saline at30min before anesthesia induction, at12h,24h,36h, after first administration, and local received2ml normalsaline（the ratio of saline to adrenalin was1：200000）before operation inincision mucosa. Group P received40mg Parecoxib Sodium at30min before anesthesia induction, at12h,24h,36h, after first administration, andlocal received2ml normal saline（the ratio of adrenalin to saline was1：200000）before operation in incision mucosa. Group L received10mlnormal saline at30min before anesthesia induction, at12h,24h,36h, afterfirst administration, and local received2ml1%Ropivacaine（the ratio ofadrenalin to Ropivacaine was1：200000）before operation in incisionmucosa. Group P+L received40mg Parecoxib Sodium at30min beforeanesthesia induction, at12h,24h,36h, after first administration, and localreceived2ml1%Ropivacaine （the ratio of adrenalin to Parecoxib Sodiumwas1：200000）before operation in incision mucosa.(Visual analoguescores)scores, patients′global evaluation of the postoperative analgesic,the number of receiving remedial analgesic drugs, nausea, vomiting,gastrointestinal bleeding,itchy skin, cardiovascular events, localanesthetics poisoning and other adverse reaction were recorded after6h、12h、24h、36h、48h of the operation.Results The VAS scores of group S was higher than group P, groupL and group P+L（the multi－analgesic group）（p＜0.05）during24h afteroperation. The VAS scores of group P+L was lower than group P at6h afteroperation（p＜0.05）. The VAS scores of group P+L, group P was lowerthan group L at12h after operation（p＜0.05）. The VAS scores of groupP+L was lower than group L at24h after operation（p＜0.05）. Patients′global evaluation of the postoperative analgesic of group P+L was higher than group P, group L(P<0.05). The number of patients receiving remedialanalgesic drugs in group P+L, group P were lower than group S(P<0.05).Conclusion Ⅰ The results showed that it was necessary toanalgesic on endonasal transsphenoidal approach for sellar resection inpostoperative period.Ⅱ The intravenous Parecoxib sodium, Ropivacaine incisioninfiltration reduced postoperative pain of endonasal transsphenoidalapproach for sellar resection.Ⅲ The efficacy of Multi－analgesic were much better than singleusing Parecoxib Sodium or Ropivacaine.Ⅳ There were no serious adverse reactions in Multi－analgesic orParecoxib sodium intravenous injection or Ropivacaine incision infiltrationtreatment process.