地佐辛复合氟比洛芬酯对腹腔镜手术患者围术期炎性细胞因子的影响和术后镇痛的效果

目的 观察地佐辛复合氟比洛芬酯对腹腔镜手术患者围术期炎性细胞因子和术后镇痛的效果.方法 择期行腹腔镜手术患者40例,随机分为地佐辛复合氟比洛芬酯组（DF组）和舒芬太尼组（S组）,每组20例.DF组用生理盐水将地佐辛0.3mg/kg与氟比洛芬酯4mg/kg稀释至100ml,S组用生理盐水将舒芬太尼2μg/kg稀释至100ml,均采用PCIA泵.记录两组患者术后疼痛评分（VAS）、舒适评分（BCS）、镇静评分（Ramsay）、PCIA有效按压次数及不良反应;分别于麻醉诱导前、术毕、术后6h、术后24 h各时点测定血浆中IL-6、IL-10和TNF-a浓度.结果 与S组比较,DF组术后4、12 h时Ramsay评分明显降低（P＜0.05）;两组患者术后VAS、BCS评分和PCIA有效按压次数差异无统计学意义（P＞0.05）.与麻醉诱导前比较,两组术后不同时点IL-6、IL-10、TNF-a浓度升高（P＜0.05）;与S组比较,DF组术后不同时点的IL-6、TNF-a浓度较低;而IL-10浓度较高（P＜0.05）.结论 地佐辛复合氟比洛芬酯可安全有效地用于腹腔镜手术患者PCIA,并可减轻术后炎性反应.

Effects of dezocine combined with flurbiprofen axetil on inflammatory cytokines and postoperative analgesia in patients with laparoscopic surgery

Objective To investigate the effects of dezocine combined with flurbiprofen axetil on inflammatory cytokines and postoperative analgesia in patients with laparoseopie surgery. Methods Forty patients scheduled for laparoscopic surgery were randomly divided into two groups, 20 cases in each group. Patients in dezocine combined with flurbiprofen axetil group （group DF） were given dezocine 0.3 mg/kg and flurbiprofen axetil 4 mg/kg, while in sufentanil group （group S） were given sufentanil 2 /~g/kg. The pump was diluted to 100 ml via PCIA after the surgery in two groups. VAS, BCS, Ramsay sedation scale, the efficient number of pressing times in 48 h, and side effects were recorded at different time points postoperatively. Blood samples were collected to determine the plasma levels of IL-6, IL-10 and TNF-a before induction of anesthesia, the end of operation and 6, 24 h after the surgery. Results The Ramsay sedation scale were significantly lower in group DF than that in group S at 4 and 12 h after the surgery （P~0.05）. No difference was found in VAS, BCS and the efficient numbers of pressing times between the two groups （P〈0.05）. Compared with pre- anesthesia, the plasma levels of IL-6, IL-10 and TNF-a were significantly high at different time points after the surgery in two groups （P〈0.05）. The levels of IL-6 and TNF-a were significantly lower, as well as IL-10 were significantly higher in group DF than that in group S （P〈0.05）. Conclusion Dezocine combined with flurbiprofen axetil can be safely and effectively used for postoperative PCIA patients with laparoscopic surgery, and can effectively relieve postoperative inflammatory cytokines.