关键词: 血液透析, 动静脉内瘘, 经皮腔内血管成形术, 镇痛剂

Abstract: Objective:To evaluate the efficacy of different analgesic drugs in alleviating pain during percutaneous transluminal angioplasty （ PTA） of arteriovenous fistulas， with the goal of guiding analgesic selection for PTA procedures. Methodology:This  retrospective  study  included  patients  who  underwent  arteriovenous  fistula  PTA  at  Huaihai  Hospital， Xuzhou Medical University，  between  January  2022  to  January  2023.  A  total  of  150  patients  were  categorized  into  three groups based on the analgesic strategy: the Control group （ n = 50， no preoperative analgesics）， the Celecoxib group （ n = 50， received preoperative celecoxib）， and the  Morphine  group  （ n = 50，  received  preoperative  morphine）.  Pain  intensity during the  procedure  was  assessed  using  the  Visual  Analogue  Scale  （ VAS）  and  the  Numeric  Rating  Scale  （ NRS）. Arteriovenous fistula patency was evaluated at 1， 3， 6， 9， and 12 months postoperatively.    Results:The median VAS pain scores were 7 （ range 3- 10） in the control group， 5 （ range 1- 10） in the celecoxib group， and 3 （ range 0- 6） in the morphine group， showing statistically significant differences （ F = 61.89， P<0.05）. Similarly， the median NRS scores were 7 （ range 2-10）  in the control group， 5 （ range 1-10）  in the celecoxib group， and 3 （ range 0-6）  in the morphine group， respectively， also with  significant  differences  （ F = 54.79，  P < 0.05）.  The  fistula  patency  rates  at  1，  3，  6，  9，  and  12 months were 94%， 88%，  78%，  70%  in  control  group， 92%，  88%，  80%，  68%  in  celecpxib  group，  and  94%，  86%， 76%， 68%  in morphine group. No significant differences in patency rates were observed among groups at any time point. Conclusion: Preoperative   administration   of   either   celecoxib   or   morphine   effectively   reduces   pain   during   PTA   of arteriovenous fistulas in  hemodialysis  patients.  Morphine  provides  superior  analgesia  compared  with  celecoxib.  Moreover， mophine and celecoxib did not affect the patency rate of primary arteriovenous fistul.

Key words: hemodialysis,  arteriovenous fistula,  percutaneous trasluminal angioplasty,  analgesics