地佐辛复合氟比洛芬酯用于腹腔镜术后镇痛的临床观察

Clinical Observation of Dezocine Combined with Flurbiprofen for Postoperative Analgesia after Laparoscopic Surgeries

目的:观察地佐辛复合氟比洛芬酯用于腹腔镜术后患者静脉自控镇痛(PCIA)的效果。方法:普外科择期行腹腔镜手术患者80例,随机分为地佐辛组(D组)和地佐辛复合氟比洛芬酯组(DF组),每组40例。术后均行PCIA。镇痛药物配方D组:地佐辛1.0mg/kg+托烷司琼5 mg+0.9%生理盐水=100 mL;DF组:地佐辛0.8 mg/kg+氟比洛芬酯2 mg/kg+托烷司琼5 mg+0.9%生理盐水=100 mL。观察并记录术后2、4、8、12、24、48 h患者安静状态和90°翻身时镇痛效果(VAS评分)和各时点镇静效果(Ramsay评分),各时间段PCIA按压次数和不良反应发生情况及生命体征变化。结果:两组患者均获得良好的镇痛效果,两组各时点安静状态下VAS评分和Ramsay评分差异均无统计学意义(P>0.05)。但各时点90:翻身时DF组VAS评分明显优于D组,两组比较差异均有统计学意义(P<0.05)。各时段PCIA按压次数无明显差异;DF组不良反应的发生率明显低于D组。结论:两种方法均可有效用于普外科腹腔镜术后镇痛。与单独使用地佐辛相比,地佐辛复合氟比洛芬酯对术后运动痛疗效更好,且不良反应少。

Objective：To investigate the effects of dezocine combined with flurbiprofen for patients control intravenous analgesia（PCIA）after laparoscopic surgeries. Method：Eighty patients scheduled for selective laparoscopic surgeries were randomly divided into dezocine group（group D） and dezocine combined with flurbiprofen group（group DF）,each group of 40 cases. Patients in group D were given dezocine 1.0 mg/kg＋Tropisetron 5 mg＋0.9%Nacl=100 mL;patients in group DF were given dezocine 0.8 mg/kg＋flurbiprofen 2 mg/kg＋Tropisetron 5 mg＋0.9%NaCl=100 mL. Write the Visual analogue score（VAS）during both silence and 90＆#176; turn over situation,Ramsay score at 2,4,8,12,24,48 h after the operation and pressing times of PCIA and the side effect. Result：Compared with group D,patients in group DF showed no significant difference in the Ramsay score and VAS during silence,but a significant decrease in VAS under 90＆#176; turn-over was observed,and the difference between the two groups were all statistically significant（P〈0.05）. The PCIA between the two groups were all no statistically significant. Less side effect were observed in group DF than in group DF. Conclusion：Administration of dezocine combined with flurbiprofen has a preferable therapeutic effect for post-operative movement pain and less side effect as compare to dezocine alone.