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目的 观察塞来昔布联合替扎尼定超前用于腰椎内镜手术镇痛的效果。方法 本研究为前瞻性随机对照试验。选取2023年3月至2023年11月因腰椎间盘突出症在北京市海淀医院住院接受手术治疗的患者，按照随机数字表法将其分为观察组和对照组，两组各纳入45例患者。观察组于术前一晚及次日晨起，给予塞来昔布200 mg及替扎尼定2 mg口服；对照组于术前一晚及次日晨起，给予塞来昔布200 mg口服。观察2组患者术后48 h内补救镇痛情况、静止期与活动期视觉模拟量表(VAS)评分、疼痛强度分级、生命体征及不良反应。结果 观察组术后48 h内补救镇痛率、补救镇痛次数、补救镇痛总剂量[分别是55.55%(25/45)次、(1.66±0.35)次、(161.25±30.58)mg]低于对照组[分别是77.78%(35/45)次、(1.97±0.42)次、(188.41±38.94)mg](χ2/t=5.000、-3.804、-3.680,P<0.05)。术后48、72 h观察组的静止期及活动期疼痛视觉模拟量表评分[分别是(1.2±0.4)、(1.9±0.4)、(1.7±0.4)、(2.0±0.6)分]低于对照组[分别是(1.9±0.6)、(2.3±0.5)、(2.6±0.8)、(2.9±0.9)分]，差异具有统计学意义(t=-6.512、-4.191、-6.750、-5.582,P<0.05)。术后48 h和72 h，观察组视觉模拟量表评分>3分患者比例[分别是11.11%(5/45)、17.78%(8/45)]低于对照组[分别是33.33%(15/45)、48.89%(22/45)]，差异具有统计学意义(χ2=6.629、9.800,P<0.05)。术后48 h内不良反应发生率观察组6.67%(3/45)和对照组4.44%(2/45)相比，差异无统计学意义(χ2=0.000,P>0.05)。结论 塞来昔布联合替扎尼定超前镇痛方案对腰椎内镜手术的术后镇痛效果显著，安全性良好。
Abstract：Objective To observe the preemptive analgesic effect of celecoxib combined with tizanidine in patients undergoing endoscopic lumbar spine surgery. Methods This prospective randomized controlled trial enrolled patients scheduled for surgical treatment of lumbar disc herniation at Beijing Haidian Hospital between March and November 2023. Participants were randomly assigned to the observation group and the control group(n=45 each) using a random number table method. The observation group received oral celecoxib(200 mg) and tizanidine(2 mg) the night before and on the morning of surgery. The control group received oral celecoxib(200 mg) the night before and on the morning of surgery. The rescue analgesia within 48 hours after surgery, Visual Analogue Scale(VAS) scores at rest and during activity, the pain intensity classification, vital signs and adverse reactions of the two groups were observed. Results Within 48 hours postoperatively, the observation group demonstrated a significantly lower rescue analgesia rate(55.55%(25/45) vs 77.78%(35/45), χ2=5.000, P<0.05), fewer rescue analgesic episodes((1.66±0.35) times vs(1.97±0.42) times, t=-3.804, P<0.001), and a lower total rescue analgesic dosage((161.25±30.58) mg vs(188.41±38.94) mg, t=-3.680, P<0.001) compared to the control group. At 48 and 72 hours postoperatively, the VAS scores for pain during the rest and activity phases in the observation group were significantly lower than those in the control group((1.2±0.4),(1.9±0.4),(1.7±0.4),(2.0±0.6) points vs(1.9±0.6),(2.3±0.5),(2.6±0.8),(2.9±0.9) points, respectively), with statistically significant differences(t=-6.512,-4.191,-6.750,-5.582, all P<0.05). At 48 and 72 hours postoperatively, the proportions of patients with VAS scores>3 in the observation group(11.11%(5/45) and 17.78%(8/45), respectively) were lower than those in the control group((33.33%(15/45) and 48.89%(22/45), respectively), with statistically significant differences(χ2=6.629, 9.800, both P<0.05). The incidence rates of adverse reactions within 48 hours after surgery were 6.67%(3/45) in the observation group and 4.44%(2/45) in the control group, and the difference was not statistically significant(χ2=0.000, P>0.05). Conclusion The preemptive analgesic regimen of celecoxib combined with tizanidine provides effective postoperative pain relief with a favorable safety profile for patients undergoing lumbar endoscopic surgery.
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基本信息:
中图分类号:R614
引用信息:
[1]滕珈瑄,蒋毅,赵金,等.塞来昔布联合替扎尼定对腰椎内镜手术的超前镇痛效果[J].中国药物应用与监测,2026,23(01):32-36.
基金信息:
2023年北京市海淀医院科研基金项目（KYQ2023010）
2026-01-25
2026-01-25