氟比洛芬酯联合舒芬太尼用于腹腔镜胆囊切除术后镇痛效果的临床研究

Combination of flurbiprofen axetil with sufentanil for postoperative analgesia in patients underwent laparoscopic cholecystectomy

目的探讨氟比洛芬酯联合舒芬太尼在腹腔镜胆囊切除术后镇痛的效果。方法选择择期全身麻醉下行腹腔镜胆囊切除术患者350例，按随机数字表法分为对照组（165例）和研究组（185例）。对照组手术结束即刻静脉连接患者自控镇痛（PCA）泵，给予舒芬太尼200μg＋0．9％氯化钠100ml；研究组于手术结束前30min给予氟比洛芬酯50mg，手术结束即刻连接PCA泵给予舒芬太尼100μg＋氟比洛芬酯50mg＋0．9％氯化钠100ml。采用视觉模拟评分（VAS）评价两组术后1、4、8、12、24h的疼痛程度，并观察有无恶心、呕吐、呼吸抑制、皮肤瘙痒等不良反应。结果研究组术后各时间点VAS明显低于对照组（P〈0．05）。对照组发生恶心61例、呕吐53例、皮肤瘙痒36例，研究组分别为25、25、15例，对照组各种不良反应发生例数明显多于研究组（P〈0．05）。两组均未发生呼吸抑制。结论腹腔镜胆囊切除术患者术后应用氟比洛芬酯联合舒芬太尼的镇痛效果好于单纯使用舒芬太尼，且可减少不良反应。

Objective To explore the analgesic effect of the combination of flurbiprofen axetil with sufentani] for patients after laparoscopic cholecystectomy. Methods Three hundred and fifty patients underwent laparoscopic surgery were divided into study group （185 cases ） and control group （165 cases ） by random digits table. The patients were treated by postoperative sufentanil 200 Ix g in 0.9% sodium chloride 100 ml in control group, while the patients in study group were treated by preoperative flurbiprofen axetil 50 mg and postoperative sufentanil 100 μg ＋ flurbiprofen axetil 50 mg in 0.9% sodium chloride 100 ml. The pain was evaluated at 1,4,8, 12,24 h after operation by visual simulation score （VAS）, the adverse effect example for nausea, vomit,respiratory depression,itch of skin were observed. Results The VAS were significantly higher in control group at various times than those in study group（P 〈 0.05 ）. Sixty-one cases with nausea, 53 cases with vomit, 36 cases with itch of skin in control group, and 25,25,15 cases in study group, the incidence of adverse effect was significantly lower in study group than that in control group （P 〈 0.05 ）. There was no respiratory depression occurring in two groups. Conclusion Flurbiprofen axetil combined with sufentanil has better analgesic effect and lower adverse effects than sufentanil alone.