得術泰在逆行性腎臟手術中降低腎盂靜脈回流疼痛的安全性和效率
吳翊豪 吳俊德 陳文祥 黃賢祥 林政鋒 林承家
基隆長庚紀念醫院 泌尿外科 外科部
Efficacy and safety of parecoxib for reducing pyelovenous backflow pain during retrograde intrarenal surgery
Yi-Hao Wu, Cheng-Feng Lin, Chun-Te Wu, Wen-hsiang Chen, Shian-shiang Huang, Cheng-Chia Lin
Department of urology, Chang Gung Memorial Hospital, Keelung, Taiwan
Purpose:
To evaluate the safety and efficacy of preoperative Parecoxib,a cox 2 inhibitorin reducing the postoperative pyelovenous backflow pain for patients undergoing retrograde intrarenal surgery( RIRS)
Materials and Methods:
We instituted a change in our institutional clinical practice starting in Jan 2016, whereby all patients undergoing RIRS were administered preoperative intravenous Parecoxib. Patients with a history of chronic renal failure (Cr over 2.5) did not receive Parecoxib. The Visual Analog Scalewere recorded after postoperative conscious recover within 24 hour during the postoperative hospitalization, and compared with a matched cohort of patients treated with RIRS at our center prior to the initiation of Parecoxib utilization. Various factors were analyzed to identify the risk factors that could predict acute postoperative pain after RIRS.
Results:
A total of 116 patients received Parecoxib during RIRS between Jan 2016 and Augest 2016. These patients were matched 1:1 to historic controls. We found that Parecoxib infusion was associated with significantly decreased of VAS, as 116 of 243 patients treated with Parecoxib received a VAS 1.57 point versus 127 of 243 matched controls VAS 3.32 point.(P <.0001). The proportion of VAS>4 score in the patients with Parecoxib infusion is much lower than that without Parecoxib (9% VS. 30%).
Conclusion:
We noted that the use of preoperative Parecoxib during RIRS was associated with a significant reduction in VAS, and was able to provide the patient a better operative quality.