氟比洛芬酯用于腹腔镜手术镇痛效果的临床研究

A clinic research for the analgesia of flurbiprofen axetil in patients undergoing laparoscopic surgery

目的通过观察氟比洛芬酯在腹腔镜手术中对心血管应激反应和血糖变化的影响,评价其在手术中的镇痛作用及效果。方法将腹腔镜手术患者60例随机分为3组,每组20例。A组以咪唑安定、依托咪酯、维库溴铵和芬太尼诱导,以丙泊酚、维库溴铵、异氟醚维持麻醉,切皮前静脉注射芬太尼2μg/kg1次,以后不再追加;B组麻醉前静脉滴注氟比洛芬酯100mg,诱导同A组,切皮前不用芬太尼;C组诱导不用芬太尼,余同B组。记录诱导前、插管时、手术开始即刻、腹腔充气时、手术开始后15min、30min、手术结束时的心率(HR)、平均动脉压(MAP)、血糖值(BS)值。结果在各时点A组与B组HR、MAP、BS及其他麻醉药用量差异无统计学意义,C组丙泊酚和异氟醚用量明显多于A组和B组(P<0.01),C组在手术后15min、30min、手术结束时的HR、MAP、BS明显高于A组和B组(P<0.05或P<0.01)。结论在腹腔镜手术中氟比洛芬酯与芬太尼有协同镇痛作用,但单独使用时对应激反应的抑制作用较弱,有较强的心血管反应,血糖明显升高,不宜代替芬太尼单独用于麻醉诱导和麻醉维持。

Objective To estimate the effect of flurbiprofen axetil by the inhibition of cardiovascular responses and the changes of blood sugar during laparoscopic surgery. Methods 60 patients were randomly divided into 3 groups with 20 cases each. In group A , patients were induced with midazolam, etomidate,vecuronium and fentanyl, and fentanyl 2 μg/kg intravenous before operation. In group B, flurbiprofen axetil 100 mg were dropped intravenous before anesthesia, the same inducation, but no fentanyl before operation. In group C, no fentanyl for inducation, the other procedures were the same to group B. Record the results of HR, MAP, BS at the time of preinducation, intubation, the begaining of surgery, charging, and 15 min,30 min, finishing of surgery. Results The results of HR, MAP and BS were higher in group C than in group A and B （ P 〈 0. 05 or P 〈 0.01 ）. Conclusion During laparoscopic surgery, flurbiprofen axetil has the joint action with fentanyl. As the intensive cardiovascular responses and raising of BS, flurbiprofen axetil alone could not be used as analgesics in place of fentanyl for anesthetic inducation and anesthetic maintanence.