·1242·ChinJMAP,2013November,Vol.30No.11中国现代应用药学2013年11月第30卷第11期32(3):728-735.[4]NELSONLE,GUOTZ,LUJ,etal.ThesedativecomponentofanesthesiaismediatedbyGABA(A)receptorsinanendogenoussleeppathway[J].NatNeurosci,2002,5(10):979-984.[5]LYDICR,BIEBUYCKJF.Sleepneurobiology:relevanceformechanisticstudiesofanaesthesia[J].BrJAnaesth,1994,72(5):506-508.[6]ALKIREMT,POMFRETTCJ,HAIERRJ,etal.Functionalbrainimagingduringanesthesiainhumans:effectsofhalothaneonglobalandregionalcerebralglucosemetabolism[J].Anesthesiology,1999,90(3):701-709.[7]SATOY,SEON,KOBAHASHIE.Thedosing-timedependenteffectsofintravenoushypnoticsinmice[J].AnesthAnalg,2005,101(6):1706-1708.[8]CHENWH,LILZ,LINPD,etal.Effectofremifentanilpreconditioningindifferentconcentrationsonhepatichypoxia-reoxygenationinjury[J].ChinJModApplPharm(中国现代应用药学),2013,30(2):125-130.[9]HIRAOJ,ARAKAWAS,WATANABEK,etal.Effectsofrestrictedfeedingondailyfluctuationsofhepaticfunctionsincludingp450monooxygenaseactivitiesinrats[J].JBiolChem,2006,281(6):3165-3171.[10]LIY,LIUZ,ZHANGJ,etal.Synchronisationmechanismsofcircadianrhythmsinthesuprachiasmaticnucleus[J].IETSystBiol,2009,3(2):100-112.[11]ALBUSH,VANSTEENSELMJ,MICHELS,etal.AGABAergicmechanismisnecessaryforcouplingdissociableventralanddorsalregionaloscillatorswithinthecircadianclock[J].CurrBiol,2005,15(10):886-893.[12]GOMPFHS,ALLENCN.GABAergicsynapsesofthesuprachiasmaticnucleusexhibitadiurnalrhythmofshort-termsynapticplasticity[J].EurJNeurosci,2004,19(10):2791-2798.[13]BONINRP,ORSERBA.GABA(A)receptorsubtypesunderlyinggeneralanesthesia[J].PharmacolBiochemBehav,2008,90(1):105-112.收稿日期:2013-03-20帕瑞昔布钠在甲状腺癌功能性颈淋巴结清扫术后镇痛效果的观察彭友,罗定存*,张卧,潘钢,丁金旺(杭州市第一人民医院,杭州310006)摘要:目的研究帕瑞昔布钠对甲状腺癌功能性颈淋巴结清扫术患者术后镇痛效果和心理状态的影响。方法根据美国麻醉师协会(ASA)分级,选择ASAI-II级择期全麻下行甲状腺癌功能性颈淋巴结清扫术患者34例,随机分为帕瑞昔布钠组和对照组。帕瑞昔布钠组于术毕即刻、术后12,24,36h分别静脉注射帕瑞昔布钠40mg;对照组在各时点给予生理盐水5mL。分别于术后6,12,24,48h记录视觉模拟镇痛评分(visualanaloguescale,VAS);并利用心理学自评量表对手术前后心理状态进行评价。结果帕瑞昔布钠组VAS于术后6,12,24h明显低于对照组(P<0.05);帕瑞昔布钠组术后各项心理学评估指标均明显优于对照组(P<0.05)。结论术后应用帕瑞昔布钠镇痛效果良好,并可改善甲状腺癌功能性颈淋巴结清扫术患者术后心理应激状态。关键词:甲状腺肿瘤;颈淋巴结清扫术;帕瑞昔布钠;镇痛中图分类号:R969.4文献标志码:A文章编号:1007-7693(2013)11-1242-03PostoperativeAnalgesicEffectofParecoxibinThyroidCancerFunctionalNeckLymphNodeDissectionPENGYou,LUODingcun*,ZHANGWo,PANGang,DINGJinwang(TheFirstPeople’sHospitalofHangzhou,Hangzhou310006,China)ABSTRACT:OBJECTIVETostudyparecoxibthyroidcancerfunctionalnecklymphnodedissectioninpatientswithpostoperativeanalgesiceffectsandpsychologicalstate.METHODSAccordingtotheAmericanSocietyofAnesthesiologists(ASA)classification,ASAI-IIlevelelectiveanesthesiathyroidcancer,thefunctionalcervicallymphnodedissectionin34patientswererandomlydividedintoparecoxibsodiumgroupandcontrolgroup.Parecoxibgroupafteroperationimmediately,12,24,36,respectivelywasintravenouslygivenparecoxibsodium40mg;5mLsalinewasadministeredateachtimepointincontrolgroup.After6,12,24and48h,mentalstateofthevisualanalogpainscore(VAS)wasrecorded.Thepsychologyself-ratingscalebef...