氟比洛芬酯用于全凭静脉麻醉下腹腔镜胆囊切除术后的镇痛效果

The analgetic effect of flurbiprofen axetil for larparoscopic cholecystectomy under total intravenous anesthesia

目的:观察不同剂量氟比洛芬酯用于全凭静脉麻醉下腹腔镜胆囊切除术后的镇痛效果和安全性。方法:将60例在全凭静脉麻醉下择期行腹腔镜胆囊切除术患者随机分为A1组(术后给予氟比洛芬酯2mg/kg,n=20)、A2组(术后给予氟比洛芬酯1mg/kg,n=20)、C组(对照组,给予生理盐水10mL,n=20)。3组均在术后患者意识恢复、VAS评分达7分时给药,记录给药后不同时间点的镇痛效果和常见不良反应的发生率。结果:A1、A2组VAS评分在12、15、20、30min和1、4、8、12、24h均显著低于C组(P<0.05),A1组VAS评分在9、12、15、20、30min和1、4、8h均显著低于A2组(P<0.05);术后因镇痛不全需哌替啶A1、A2组显著少于C组(P<0.05)3组患者不良反应的发生率无统计学意义(P>0.05)。结论:氟比洛芬酯可安全地用于腹腔镜下胆囊切除术术后静脉镇痛,尤其给予2mg/kg氟比洛芬酯具有起效时间短、镇痛效果强且完全、持续时间长和副作用未增加的优点。

Objective To investigate the analgetic effect and safety of flurbiprofen axetil at different doses for larparoscopic cholecystectomy under total intravenous anesthesia. Method Sixty ASA Ⅰ or Ⅱ patients were randomized to receive 2 mg/kg of flurbiprofen （group A1）, lmg/kg of flurbiprofen （group A2）, or 10 mL of saline solution （group C） after recovery of consciousness and achieving a VAS score of 7. The analgetic effect of flurbiprofen and its adverse effects were observed at different time points. Results The VAS scores were markedly lower in groups A1 and A2 than in group C 12, 15, 20, 30 min, 1, 4, 8, 12, and 24 h after administration （P 〈 0.05） and the scores in group A1 were significantly lower than those in group A2 at 9, 12, 15, 20, 30 min, 1, 4, and 8 h （P〈 0.05）. The additional use of dolantin for poorly controlled postoperative pain was evidently less in groups A1 and A2 than in group C （P 〈 0.05）. There was no significant difference in the incidence of adverse effects among the three groups （P 〈 0.05）. Conclusion Flurbiprofen axetil can be safely used for relieving postoperative pain in patients undergoing larparoscopic cholecystectomy, especially at a dose of 2 mg/kg because it has shorter time to onset, longer duration of action, greater analgetic effects, and less adverse effects.