术前不同时间应用氟比洛酚酯对妇科腹腔镜术后镇痛效果的影响

THE EFFECT OF FLURBIPROFEN AXETIL TO PREOPERATIVE APPLICATION IN DIFFERENT TIME FOR ANALGESIA OF POST-GYNECOLOGICAL LAPAROSCOIPCAL SURGERY

目的:评价术前不同时间应用氟比洛酚酯对妇科腹腔镜患者术后的超前镇痛效应。方法:选择ASA-Ⅱ级择期行妇科腹腔镜术患者60例,随机分4组,每组15例,随机均分为术前30min应用氟比洛酚酯组(A组)、术前15min应用氟比洛酚酯组(B组)、术前5min应用氟比洛酚酯组(C组)和等量生理盐水对照组(D组)。4组患者术后均用自控硬膜外镇痛泵(PCEA)。于术后4h,8h,16,24h,48h随访病人,观察病人疼痛情况并进行相应的VSA评分,记录首次应用PCEA时间、镇痛药累积用量。结果:A,B,C三组患者术后各观察点的VAS评分均低于D组(P<0.05),A,B,C三组差异无显著性(P>0.05),但其中B组患者的VAS评分曲线较为平稳。A,B,C三组患者术后首次要求PCEA时间均晚于D组(P<0.05),但组间差异无显著性(P>0.05)。A,B,C三组术后镇痛药用量均小于D组(P<0.05),其中B组患者患者用量最少(P<0.05)。结论:术前15min应用氟比洛芬醋静脉注射对于妇科腹腔镜手术术后有最佳的镇痛效果。

Objective：To evaluate effect of preemptive analgesia with flurbiprofen axetil used preoperation in different time.Methods ：60 patients（ASA I-II）undergoing LC with gynecological diseases were randomly divided into four groups：Group A（n = 15）received flurbiprofen axetil（i.v.10 mg·kg-1）in 30 minutes before operation;Group B（n=15）received flurbiprofen axetil（i.v.10 mg·kg-1）in 15 minutes before operation;Group C（n = 15）received flurbiprofen axetil（i.v.10 mg·kg-1）in 5 minutes before operation;Group D（n = 15）received tales doses NS（i.v.10 mg·kg-1）before operation.The patient-controlled epidural analgesia（PCEA）devices were used in all patients after operation.The effectiveness was assessed postoperatively using the visual analogue scale（VAS）at4h,8h,12h,24h,48h after surgery,the time of first PCEA activation,and then calculating the total consumption of analgesic after operation.Results：Patients in group A,B,C reported significantly lower pain scores（P 0.05）than group D,and pain scores in A,B,C were no signiciantly different（P 0.05）,but pain scores-time curve in group B was more stable than the others.For the time of first PECA activation,Patients in group A,B,C also significantly later（P 0.05）than group D,but there were no signiciantly different in groups A,B,C.And for calculating the total consumption of analgesic,group D was more than the others（P0.05）,and the group B was the least in four groups（P0.05）.Conclusion：Flurbiprofen axetil was the best effect ot postoperative analgesia of gynecological laparoscopical surgery before used in 15 minitues preoperation.