氟比洛芬酯联合镇痛对日间胆囊手术镇痛效果的比较
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摘要
目的:探讨不同镇痛方式对日间腹腔镜胆囊手术术后疼痛的影响。方法:将60例行日间腹腔镜胆囊手术的患者随机分成氟比洛芬酯联合地佐辛组(D组)、氟比洛芬酯联合罗哌卡因局部浸润组(R组),两组均采用全身麻醉,氟比洛芬酯50 mg于麻醉开始前10 min静脉注射, D组于手术结束前15 min静脉滴注地佐辛0.1 mg/kg, R组手术结束前采用0.5%罗哌卡因6 ml/处局部浸润。结果:T_1、T_5时刻两组VAS评分差异不大,T_2、T_3、T_4时刻R组VAS评分较D组低,差异有统计学意义(P<0.05);术后IL-6、INF-α含量均较术前增高;与R组比较,D组升高较明显,差异有统计学意义(P<0.05);D组与R组之间相比较,R组出现不良反应的例数少。结论:氟比洛芬酯联合地佐辛与氟比洛芬酯联合罗哌卡因局部浸润的镇痛模式具有减轻术后疼痛、加快恢复的效果;但氟比洛芬酯联合罗哌卡因局部浸润效果更显著。
Objective To investigate the effect of different analgesic methods on pain after day-case laparoscopic cholecystectomy(DLC).Method 60 cases of DLC patient were randomly divided into flurbiprofen axetil combined with dezocine group(D) and flurbiprofen axetil combined with local infiltration of ropivacaine group(R), two groups were treated with general anesthesia, flurbiprofen 50 mg was injected intravenously 10 minutes before anesthesia, group D before the end of surgery 15 min intravenous injection of dezocine 0.1 mg/kg, Local infiltration of 0.5% ropivacaine at 6 ml/point before the end of operation in group F.Results There was no significant difference in VAS score between the two groups at T_1 and T_5, and the VAS score of group R at T_2, T_3 and T_4 was lower than that of group D(P<0.05), both of which were statistically significant.After operation, the content of IL-6 and INF-α was higher than that before operation,Compared with R group,D group increased significantly(P<0.05).In group D and group R, the number of adverse reactions in group R was fewer.Conclusion The flurbiprofen axetil combined with dezocine and flurbiprofen axetil combined with local infiltration of ropivacaine has the effect of relieving postoperative pain and accelerating the recovery;However,flurbiprofen axetil combined with local infiltration of ropivacaine is more useful.
Objective To investigate the effect of different analgesic methods on pain after day-case laparoscopic cholecystectomy(DLC).Method 60 cases of DLC patient were randomly divided into flurbiprofen axetil combined with dezocine group(D) and flurbiprofen axetil combined with local infiltration of ropivacaine group(R), two groups were treated with general anesthesia, flurbiprofen 50 mg was injected intravenously 10 minutes before anesthesia, group D before the end of surgery 15 min intravenous injection of dezocine 0.1 mg/kg, Local infiltration of 0.5% ropivacaine at 6 ml/point before the end of operation in group F.Results There was no significant difference in VAS score between the two groups at T_1 and T_5, and the VAS score of group R at T_2, T_3 and T_4 was lower than that of group D(P<0.05), both of which were statistically significant.After operation, the content of IL-6 and INF-α was higher than that before operation,Compared with R group,D group increased significantly(P<0.05).In group D and group R, the number of adverse reactions in group R was fewer.Conclusion The flurbiprofen axetil combined with dezocine and flurbiprofen axetil combined with local infiltration of ropivacaine has the effect of relieving postoperative pain and accelerating the recovery;However,flurbiprofen axetil combined with local infiltration of ropivacaine is more useful.
引文
[1] 尹述洲,张莹.帕瑞昔布超前镇痛在腹部手术麻醉中的临床应用[J].山东医药,2011,51(29):91.
[2] Malyszko J,Przybylowski P,Malyszko J,et al.Tumor necrosis factor-related apoptosis-inducing ligand is a marker of kidney function and inflammaion in heart and kidneytransplantrecipients[J].Transplant Proc,2011,43(5):1877.
[3] Kehlet H,Jensen TS,Woolf CJ.Persistent postsurgical pain:riskfactors and prevention [J].Lancet,2006,367(12):1618.
[4] 岳修勤.地佐辛与芬太尼应用于术后静脉镇痛的临床效果比较[J].中国疼痛医学杂志,2010,16(4):255.
[5] Gupa A,Thorn SE,Axelsson K,et al.Postoperative pajn relief using intermittent injection of 0.5% ropivacaine through a eather afterlaparoseopic cholecystectomy[J].Anesth Analg,2002,95(2):450.
[6] 梁汉生,冯艺,刘怡昭,等.氟比洛芬酯联合戳口局部浸润对腹腔镜胆囊切除术后镇痛的临床观察[J].北京大学学报(医学版),2011,43(5):753.
[7] Labaille T,Mazoit JX,Paqueron X,et al.The clinical efficacy and pharmacokineties of intraperitoneal ropivaeaine for laparoscopic cholecystectomy[J].Anesth Analg,2002,94(1):100.
[2] Malyszko J,Przybylowski P,Malyszko J,et al.Tumor necrosis factor-related apoptosis-inducing ligand is a marker of kidney function and inflammaion in heart and kidneytransplantrecipients[J].Transplant Proc,2011,43(5):1877.
[3] Kehlet H,Jensen TS,Woolf CJ.Persistent postsurgical pain:riskfactors and prevention [J].Lancet,2006,367(12):1618.
[4] 岳修勤.地佐辛与芬太尼应用于术后静脉镇痛的临床效果比较[J].中国疼痛医学杂志,2010,16(4):255.
[5] Gupa A,Thorn SE,Axelsson K,et al.Postoperative pajn relief using intermittent injection of 0.5% ropivacaine through a eather afterlaparoseopic cholecystectomy[J].Anesth Analg,2002,95(2):450.
[6] 梁汉生,冯艺,刘怡昭,等.氟比洛芬酯联合戳口局部浸润对腹腔镜胆囊切除术后镇痛的临床观察[J].北京大学学报(医学版),2011,43(5):753.
[7] Labaille T,Mazoit JX,Paqueron X,et al.The clinical efficacy and pharmacokineties of intraperitoneal ropivaeaine for laparoscopic cholecystectomy[J].Anesth Analg,2002,94(1):100.