地佐辛复合氟比洛芬酯对妇科腔镜术后的影响

Effects of dezocine combined with flurbiprofen axefil after gynecology laparoscopic surgery

目的观察地佐辛复合氟比洛芬酯对妇科腔镜术后疼痛及炎性细胞因子的影响。方法回顾分析我院自2013年9月至2014年1月所行妇科腔镜手术治疗的患者80例,随机分为两组:地佐辛复合氟比洛芬酯组(DF组,n=40)和舒芬太尼组(S组,n=40)。DF组用生理盐水将地佐辛0.3 mg/kg+氟比洛芬酯2 mg/kg稀释至100 ml,S组用生理盐水将舒芬太尼2μg/kg稀释至100 ml,均采用静脉自控镇痛(PCIA)泵。记录术后6 h、12 h、24 h、48 h视觉模拟评分(VAS)、布氏舒适评分(BCS)、Ramsay镇静评分、PCIA有效按压次数及不良反应;分别于麻醉诱导前(T1)、术毕(T2)、术后6 h(T3)、术后24 h(T4)各时点测定血清白细胞介素-6(IL-6)、IL-10和肿瘤坏死因子α(TNF-α)浓度。结果与S组比较,DF组术后6、12 h Ramsay评分明显降低(P<0.05);两组患者术后VAS、BCS评分和PCIA有效按压次数差异无统计学意义。与T1比较,两组术后不同时点IL-6、IL-10、TNF-α浓度显著升高(P<0.05);与S组比较,DF组术后不同时点的IL-6、TNF-α浓度显著降低;而IL-10浓度显著升高(P<0.05)。结论地佐辛复合氟比洛芬酯可以安全有效地用于妇科腔镜手术患者PCIA,可减轻炎性反应。

Objective To investigate the effects of dezocine combined with flurbiprofen axetil on postoperative analgesia and inflammatory cytokines after gynecological laparoscopic surgery.Methods A retrospective study covers the cases from Sep.2013 to Jan.2014 was performed,eighty patients with selective gynecological laparoscopic surgery were randomly divided into two groups.Patients in dezocine combined with flurbiprofen axetil group （DF group,n =40）were given dezocine 0.3 mg/kg and flurbiprofen axefil 2 mg/kg,while in sufentanil group （S group,n =40）were given sufentanil 2 μg/kg.The pump was diluted to 100 ml via PCIA after surgery for 48 h in two groups.The visual analog scale （VAS）,bruggrmann comfort scale （BCS）,ramsay sedation scale,the efficient number of pressing times with in 48 h,and side effects were recorded at different points postoperatively.Blood samples were collected to determine the serum levels of interleukin （IL）-6,IL-10 and tumor necrosis factor （TNF）-αbefore induction of anesthesia （T1）,the end of operation （T2）and 6 h （T3）,24 h （T4）after surgery.Results The Ramsay sedation scale were significantly lower in group DF than that in group S at 6 and 12 h after surgery （P 〈0.05）.No difference was found in VAS,BCS and the efficient numbers of pressing times between the two groups. Compared with pre-anesthesia,the levels of IL-6,IL-10 and TNF-αwere significantly high at different points after surgery in two group （P 〈0.05）.The levels of IL-6 and TNF-αwere significantly lower,as well as IL-10 were significantly higher in the group DF than that in group S （P 〈0.05）.Conclusion Dezocine combined with flurbiprofen axetil can be safely and effectively used for postoperative PCIA patients after gynecological laparoscopic surgery,and effectively relieve inflammation cytokines after surgery.