氟比洛芬酯联合罗哌卡因用于腹腔镜胆囊切除术后镇痛效果的观察

目的探讨氟比洛芬酯复合罗哌卡因用于腹腔镜胆囊切除术(LC)患者术后镇痛的效果。方法择期行腹腔镜胆囊切除术患者80例,ASAⅠ～Ⅱ级,年龄18～65岁,体重44.5～91 kg,随机分成两组:氟比洛芬酯组(F组)和氟比洛芬酯联合罗哌卡因组(FR组),各40例。两组患者均于麻醉诱导前15 min和术后12 h静脉注射氟比洛芬酯1 mg/kg;FR组切皮前采用0.5%罗哌卡因于切口周围、皮下、肌肉、腹膜浸润麻醉(剑突下10 ml,脐上和右腹部切口分别浸润5 ml),F组则使用等量生理盐水。术后VAS评分>3分时,肌肉注射哌替啶50 mg。术后采用视觉模拟评分法(VAS)评估患者术后2、6、12及24 h的疼痛感觉程度,并记录所有患者术后24 h内恶心呕吐发生情况和哌替啶的使用例数。结果两组患者术后恶心、呕吐发生率差异无统计学意义(P>0.05);FR组术后2、6、12及24 h各时间点VAS评分低于F组(P<0.01);与F组比较,FR组哌替啶使用例数减少(P<0.01)。结论氟比洛芬酯联合罗哌卡因多模式镇痛用于LC术后镇痛,效果确切。

Effect of flurbiprofen combined with ropivacaine local infiltration on postoperative analgesia after laparoscopic cholecystectomy

Objective Toinvestigate the effects of postoperative analgesia after cholecystectomy using intravenous flurbiprofen combined with ropivacaine incision infiltration.Methods Forty ASAⅠor Ⅱ patients,aged 18-65 yr,weighing 44.5-91kg,scheduled for traditional laparoscopic cholecystectomy,received standard general anesthesia,were randomly divided into 2 groups(n=40 each): flurbiprofen axetil + 0.9% normal saline(group F) and flurbiprofen axetil + 0.5% ropivacaine(group FR).Flurbiprofen axetil 1mg/kg was injected intravenously 15 min before the induction of anesthesia and it was repeated in the first 12 h after surgery.Immediately before skin slit,0.9% normal saline or 0.5% ropivacaine was injected for local infiltration in each group.VAS scores were maintained ≤ 3 after operation.When VAS scores > 3,pethidine 50 mg was injected intramuscularly.The effects of analgesia after operation were assessed by visual analogue scale(VAS) at 2,6,12,24 hours after operation,and the side effects(nausea and vomiting) and pethidine usage were recorded within 24h after operation.Results VAS of group FR was lower than that of group F during 24 hours after operation(P<0.01).Compared with group F,the requirement for pethidine was significantly decreased in group FR(P<0.01).Conclusion Intravenous flurbiprofen axetil combined with ropivacaine for multimodal analgesic strategy could significantly reduce postoperative pain after laparoscopic cholecystectomy.