观察氟比洛芬酯术后镇痛及血液中白介素-6的变化

目的观察氟比洛芬酯（FA）用于妇科腹腔镜术后镇痛效果及血中白介素-6（IL-6）的变化。方法择期行妇科腹腔镜手术的患者80例，分为4组（n=20）。A组，手术结束前30min给予FA50nag和曲马多（1mg／kg）；B组，麻醉诱导前5min给予FA50mg，手术结束前30min给予曲马多（1mg／kg）；C组，麻醉诱导前5rain给予FA50rag；D组，手术结束前30rain给予曲马多（2ms／ks）。对各组患者术前、术后不同时点采取静脉血检测IL-6水平，同时进行VAS评分，比较各组手术结束后不同时点的VAS评分及血IL-6水平变化情况。结果Tl时间点A、B、C组VAS评分明显低于D组（1．40±0．26，1．67±O．37，1．60±O．42VS3．134±2．32，P〈0．05）；在T24时间点A、B两组VAS评分明显低于D组（2．13±1．24，2．004±1．25VS3．53±1．87，P〈0．05）。在T1时间点D组血中IL-6浓度明显高于其他三组（12．26±6．56VS2．94±2．55，3．374±2．43VS2．93±1．16，P〈0．05）。结论氟比洛芬酯复合曲马多用于妇科腹腔镜术后各时点的镇痛效果优于单独使用其中的任一种药物。氟比洛芬酯可抑制IL-6升高，有效对抗手术创伤引起的炎症反应。

To observe the changes of IL-6 in gynecological laparoscopic surgery used flurbiprofen axetil for analgesia

Objective To study the flurbiprofen axetil (FA) for postoperative analgesia of gynecological laparoscopic surgery and the changes of interleukin-6 in blood.Methods 80 cases were selected for gynecologic laparoscopic surgery,the patients were randomly divided into 4 groups with 20 cases each group.Group A was given FA 50 mg and tramadol 1 mg/kg 30 minutes before the end of surgery.Group B was given FA 50 mg 5 minutes before induction of anesthesia and given tramadol 1 mg/kg 30 minutes before the end of surgery,and group C was given FA 50 mg five minutes before induction of anesthesia.Group D was given tramadol 2 mg/kg 30 minutes before the end of surgery.After the surgery,the VAS was observed in real-time of wake up (T1),and 2 hours (T2),6 hours (T6) and 24 hours (T24) after operating.The blood of each group was taken at the different time points including arriving in the room (T0),waking up (T1) and 6 hours (T6) after operating.The blood samples were hold for 30 minutes and centrifuged (3000 r/min,10 min),and IL-6 was detected using double-antibody sandwich ABC-ELISA.Results The experiments showed that VAS in T1 time point of group A,B,C were lower than that of group D(1.40±0.26,1.67±0.37,1.60±0.42 vs 3.13±2.32).In T24 time point,VAS of group A,B were also lower than that of group D(2.13±1.24,2.00±1.25 vs 3.53±1.87),the differences were significant (P＜0.05).The experiments showed that concentration of IL-6 in group D was higher than that in group A,B,C at the T1 time point (12.26±6.56 vs 2.94±2.55,3.37±2.43 vs 2.93±1.16,P＜0.05).Conclusions The postoperative analgesic effect of Flurbiprofen axetil combined with tramadol on the ogynecological laparoscopic was superior to using any of the drug alone.Flurbiprofen axetil could inhibit increasing of IL-6 and have an effect against the inflammatory response induced by surgical trauma,and it has a good analgesic effect.