氟比洛芬酯不同给药方式对腹腔镜胆囊切除术后镇痛的影响

目的探讨氟比洛芬酯不同给药方式对腹腔镜胆囊术切除术(LC)术后镇痛的影响。方法 60例ASAI～II级择期行LC患者,随机分为A、B、C三组,每组20例。三组患者麻醉维持采用持续静脉泵注雷米芬太尼和丙泊酚。A组在术毕时静注氟比洛芬酯1mg/kg,B组在气管插管后静注氟比洛芬酯1mg/kg,C组在气管插管后和术毕时各静注氟比洛芬酯1mg/kg。观察三组患者术后4、8、12、24h疼痛视觉模拟评分(VAS),并记录麻醉苏醒拔管时间、不良反应及术后镇痛药使用等情况。结果 C组术后4、8、12、24hVAS明显低于B组(P<0.05)和A组(P<0.01);术后要求使用镇痛药的时间,C组明显长于B组(P<0.05)和A组(P<0.01);使用镇痛药的比例,C组明显少于B组(P<0.05)和A组(P<0.01),三组不良反应发生率差异无统计学意义。结论手术前及术毕时各静注氟比洛芬酯1mg/kg可以产生较好的术后镇痛,减少阿片药的用量,同时不影响麻醉恢复。

Administration of Flurbiprofen Axetil in Different Ways on Analgesia after Laparoscopic Cholecystectomy

Objective To explore the administration of flurbiprofen in different ways on analgesia after laparoscopic cholecystectomy(LC).Methods 60 elective LC patients with ASA I～II were randomly divided into A,B,C groups with 20 patients each.The three groups of patients maintained anesthesia with continuous intravenous infusion of remifentanil and propofol.Group A were intravenously infused flurbiprofen 1 mg/kg at the completion of surgery,Group B were intravenously infused flurbiprofen 1 mg/kg after intubation,Group C were intravenously infused fluoride axetil 1 mg/kg after intubation and the completion of surgery,to observe the three groups of patients 4,8,12,24 h pain visual analogue score(VAS),and record the anesthesia extubation,adverse events and postoperative analgesic use and so on. Results 4,8,12,24 h VAS in Group C were significantly lower than that in Group B(P<0.05)and Group A(P<0.01);Patient requirement of analgesic time in Group C was significantly longer than that in Group B(P<0.05)and Group A(P<0.01);Use of analgesic ratio in Group C was significantly less than that in Group B(P<0.05)and Group A(P<0.01);The three groups had no significant difference of adverse reaction rate.Conclusion The preoperative and intraoperative completion when the intravenous injection of flurbiprofen 1 mg/kg can produce better postoperative analgesia,decrease opioid drug dosis,without affecting the anesthesia recovery.