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【drug-news】帕瑞考昔在治疗腰椎术后疼痛中的作

www.ncbi.nlm.nih.gov/pubmed/18197096
Effect of parecoxib on postoperative pain after lumbar spine surgery: a bicenter, randomized, double-blinded, placebo-controlled trial.
Jirarattanaphochai K, Thienthong S, Sriraj W, Jung S, Pulnitiporn A, Lertsinudom S, Foocharoen T.
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. kitjir@kku.ac.th
STUDY DESIGN: A bicenter randomized, patients, healthcare providers, and data collectors blind placebo-controlled trial in multimodal analgesia for postoperative lumbar spine surgery was conducted. OBJECTIVE: To assess the efficacy and safety of parecoxib on postoperative pain management after posterior lumbar spine surgery. SUMMARY OF BACKGROUND DATA: Systematic reviews suggest that cyclo-oxygenase-2 inhibitors are an effective treatment for acute postoperative pain. However, previous trials on lumbar spine surgery showed equivocal efficacy of cyclo-oxygenase-2 inhibitors for postoperative pain relief. METHODS: In this study, 120 patients undergoing posterior lumbar discectomy, spinal decompression, or spinal fusion were stratified based on the surgical procedure to 3 groups (n = 40) and randomly allocated to receive multidoses of parecoxib 40 mg/dose or placebo. Efficacy was assessed by total morphine used from patient-controlled analgesic pump, pain intensity, pain relief, and the patient's subjective rating of the medication. RESULTS: Parecoxib 40 mg reduced the total amount of morphine required over 48 hours by 39% relative morphine reduction compared with placebo (P = 0.0001). Pain at rest was reduced by 30% (P = 0.0001). Ninety percent of patients given parecoxib experienced at least 50% maximum total pain relief compared with 58% treated with placebo. The number-needed-to-treat for 1 patient to have at least half pain relief was 3.1 (2.0-4.6). Patients' subjective rating of the medication was described as "excellent, good, and fair" by 48%, 43%, and 8% in the parecoxib group, respectively, compared with 21%, 50%, and 28% of placebo patients (P = 0.004). Overall adverse effects of patients receiving parecoxib and morphine were comparable to those receiving morphine alone. CONCLUSION: The present study demonstrates that the perioperative administration of parecoxib with patient-controlled analgesic morphine after lumber spine surgery resulted in significantly improved postoperative analgesic management as defined by reduction in opioid requirement, lower pain scores, and higher patients' subjective rating of the medication.

本人已认领该文编译,48小时后若未提交译文,请其他战友自由认领。 Effect of Parecoxib on Postoperative Pain After Lumbar Spine Surgery
帕瑞考昔在治疗腰椎术后疼痛中的作用
A Bicenter, Randomized, Double-Blinded, Placebo-Controlled Trial Kitti Jirarattanaphochai, MD,* Somboon Thienthong, MD,? Wimonrat Sriraj, MD, MS,?Surachai Jung, MD,* Aksorn Pulnitiporn, MD,? Somkid Lertsinudom, MD,§ and Thanit Foocharoen, MD§
一个二分布中心,随机化,双盲的,安慰剂对照试验由Kitti Jirarattanaphochai, MD,* Somboon Thienthong, MD,? Wimonrat Sriraj, MD, MS,?Surachai Jung, MD,* Aksorn Pulnitiporn, MD,? Somkid Lertsinudom, MD,§ and Thanit Foocharoen, MD实施。
StudyDesign. A bicenter randomized, patients, healthcare providers, and data collectors blind placebo-controlled trial in multimodal analgesia for postoperative lumbar spine surgery was conducted.
研究设计:一个二分布随机的,患者,健康护理提供者,数据收集者,在腰椎术后多形止痛中实施双盲安慰剂对照试验。
Objective. To assess the efficacy and safety of parecoxib on postoperative pain management after posterior lumbar spine surgery.
目的:为了评估帕瑞考昔在腰椎术后痛治疗中效果与安全性。
Summary of Background Data. Systematic reviews suggest that cyclo-oxygenase-2 inhibitors are an effective treatment for acute postoperative pain. However, previous trials on lumbar spine surgery showed equivocal efficacy of cyclo-oxygenase-2 inhibitors for postoperative pain relief.
背景数据的摘要:系统性回顾显示环氧酶-2抑制剂对于急性术后痛的治疗的有效的。然而,腰椎手术预实验显示它在缓减术后痛疼的效果不明显。
Methods. In this study, 120 patients undergoing posterior lumbar discectomy, spinal decompression, or spinal fusion were stratified based on the surgical procedure to 3 groups (n=40) and randomly allocated to receive multidoses of parecoxib 40 mg/dose or placebo. Efficacy was assessed by total morphine used from patient-controlled analgesic pump, pain intensity, pain relief, and the patient’s subjective rating of the medication.
方法:这项研究中,120个经受腰椎间盘切除术,椎管减压,或者脊柱融合术的病人基于外科步骤分成三组(n=40),并且随机分配接受多剂量40 mg/剂量的帕瑞考昔或者安慰剂。通过对照病人止痛泵使用的总吗啡量,痛疼的强度,痛疼的缓减,和病人的主观药物治疗等级来评估疗效。

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作者:admin@医学,生命科学    2010-09-24 17:11
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