氟比洛酚酯联合罗哌卡因对腹腔镜下全子宫切除术患者镇痛效果的影响

目的观察氟比洛酚酯联合罗哌卡因对腹腔镜下全子宫切除术患者术后镇痛的效果。方法选择行择期腹腔镜全子宫切除术患者150例,随机分氟比洛芬酯组（F组,n=50）、罗哌卡因组（R组,n=50）和氟比洛芬酯＋罗哌卡因组（FR组,n=50）。F组给予氟比洛芬酯100 mg加入至0.9%生理盐水100 ml中缓慢静滴,R组予0.5%罗哌卡因于伤口及手术创面局部浸润,FR组在给予氟比洛芬酯100 mg基础上同时给予0.5%罗哌卡因局部浸润。采用视觉模拟评分（VAS）测定患者术后2 h、8 h、12 h、24 h、36 h、48 h疼痛程度及术后头晕、恶心、呕吐的发生率及哌替啶使用情况。结果与F组比较,FR组在术后8 h、24 hVAS评分明显降低,差异有统计学意义（P〈0.05）;12 h VAS评分降低更为明显,差异有显著统计学意义（P〈0.01）。与R组比较,FR组在12 h时VAS评分明显降低,差异有统计学意义（P〈0.05）。三组术后头晕、恶心及呕吐之间比较差异无统计学意义。与F组及R组相比,FR组哌替啶使用率明显减少,差异有统计学意义（P〈0.05）。结论氟比洛酚酯联合罗哌卡因对腹腔镜下全子宫术患者具有较好的镇痛效果,并且并发症少,具有较好的临床使用价值。

Effect of flurbiprofen combined ropivacaine on postoperative analgesia after laparoscopic panhysterectomy

Objective To investigate the effects of postoperative analgesia after laparoscopic panhysterectomy using intravenous flurbiprofen combined with ropivacaine incision infiltration. Methods One hundred and fifty patients undergoing selective laparoscopic panhysterectomy were selected. They were randomly allocated to three groups： flurbiprofen group（F group, n=50）, ropivacaine group（R group, n=50） and flurbiprofen combined with ropivacaine group（FR group, n=50）. Group F was given flurbiprofen 100 mg plus 0.9% NaCl 100 ml by intravenous injection slowly. Group R, the wound and surgical wound was locally infiltrated with 0.5% ropivacaine, Group RF received venoclysis of flurbiprofen 100 mg combined with local infiltration anesthesia indued by 0.5% ropivacaine. The postoperative pain of the patients at 2, 8, 12, 24, 36 and 48 h in 3 groups, was evaluated using a visual analogue scale（VAS）,the relative parameters of postoperative dizziness, nausea, vomiting and using or not pethidine were also documentedduring the research period. Results Compared to F group, postoperative VAS decreased at 8, 24 h（P〈0.05） and VAS decreased significantly at 12 h in FR group（P〈0.01）. Compared to F and R groups, no pethidine was used in FR group（P〈0.05）.There wasn＇t significance difference among compared of nausea and vomiting and dizzy after operation, FR group the usage rate of pethidine was reduced than F and group. Conclusion Intravenous flurbiprofen combined with ropivacaine infiltration anesthesia is a safe and effective for laparoscopic panhysterectomy and is appropriate for more applications.