氟比洛芬酯应用于腹腔镜胆囊切除术超前镇痛的临床研究

Clinical Study of Flurbiprofen Axetil Used in Preemptive Analgesia of Laparoscopic Cholecystec-tomy

[目的]研究氟比洛芬酯超前镇痛对减少异丙酚复合瑞芬太尼全凭静脉麻醉术后疼痛及不良反应的效应。探讨氟比洛芬酯超前镇痛的给药方式、时间、剂量。[方法]选择期腹腔镜胆囊切除术患者40例，随机分为A、B两组，每组20例。A组切皮前静脉注射氟比洛芬酯100mg；B组气腹后即刻注射氟比洛芬酯100mg。双盲法观察患者术后2h（T1）、6h（T2）、24h（T3）的VAS评分。观察围拔管期的血压（BP）、心率（HR）、脉搏血氧饱和度（SpO2）以及躁动、呛咳、拔管后10min的Ramsay镇静评分情况。[结果]VAS评分于T1时A组低于B组（P＜0．05）。两组患者不良反应及拔管后Ramsay评分差异无统计学意义（P＞0．05）。[结论]氟比洛芬酯能有效缓解腹腔镜胆囊切除术后疼痛，手术前给药镇痛效果优于手术开始后给药，并能维持满意的镇静。

[Objective] To study the efficacy of preemptive analgesia with flurbiprofen axetil on reducing postoperative pain and adverse reaction of propofol combined with remifentanil for total intravenous anesthesia , and to explore administration method ,time and dosage of preemptive analgesia with flurbiprofen axetil .[Meth-ods] Totally 40 patients undergoing laparoscopic cholecystectomy were chosen and randomly divided into group A（ n=20） and group B（ n =20） .Group A received intravenous flurbiprofen axetil 100mg before skin inci-sion ,while group B received intravenous flurbiprofen axetil 100mg immediately at pneumoperitoneum .Double blind method was used to observe VAS score 2h（T1 ） ,6h（T2 ） and 24h（T3 ） after operation .Blood pressure （BP） ,heart rate（HR） ,SpO2 ,agitation ,cough during the extubation and Ramsay sedation score 10min after extubation were observed .[Results]VAS scores in group A at T1 were lower than those in group B （ P 〈0 .05） .There was no significant difference in the incidence of adverse reaction and Ramsay score after extuba-tion between two groups（ P 〉 0 .05） .[Conclusion] Flurbiprofen axetil can effectively relieve the pain after laparoscopic cholecystectomy .The analgesic efficacy of preoperative administration is better than postoperative administration .Preoperative administration can maintain satisfactory sedative effect .