氟比洛芬酯超前镇痛在妇科腹腔镜手术中的应用

Application of flurbiprofen axetil for preemptive analgesia in patients undergoing gynecological laparoscopic surgery

目的观察氟比洛芬酯超前镇痛在妇科腹腔镜手术中的应用效果。方法择期腹腔镜下行妇科手术患者52例,ASA I^II,按照随机数字表法分为A组与B组各26例。A组在麻醉诱导前静脉注射氟比洛芬酯50 mg复合地塞米松10mg和昂丹司琼4 mg;B组在麻醉诱导前静脉注射相同容量的生理盐水。观察两组苏醒时间以及拔管后即刻、拔管后1、2、3、8h的收缩压(SBP)、心率(HR)、镇痛评分(视觉模拟评分法,VAS)、镇静评分(Ramsay评分法)和不良反应,记录两组患者术后24 h内追加镇痛药的情况。结果 A组拔管后各时点的VAS评分明显低于B组(P<0.05),恶心呕吐的发生率及术后24 h内追加镇痛药的患者明显少于B组(P<0.05)。两组Ramsay评分、苏醒时间、SBP、HR的变化和不良反应比较差异无统计学意义(P>0.05)。结论氟比洛芬酯超前用于妇科腹腔镜手术,具有良好的镇痛效果,不良反应发生率低,不影响全麻苏醒时间,安全性高。

Objective To observe the effects of preemptive analgesia of flubiprofen axetil in patients undergoing gynecological laparoscopic surgery.Methods Fifty-two adult patients（ASA I^II）scheduled for selective gynecological laparoscopic surgery were randomly divided into A and B groups,26 in each group.Before induction of general anesthesia,patients in the group A received flurbi-profen axetil 50 mg combined with dexamethasone 10 mg and ondansetron 4 mg,while patients in the group B received the equivalent volume of saline.When operation was finished,the awaking time of anesthesia,systolic blood pressure（ SBP） ,heart rate（ HR） ,the pain score of visual analogue scale（ VAS） ,the sedation grades of Ramesay score and incidence of adverse events were recorded at the emer-gence from extubation,1,2,3 and 8 h after extubation.The cases of additonal analgesics were recorded within 24 h after operation.Re-sults At each observation point,the VAS in the group A were significantly lower than that in the group B（P〈0.05）.The Ramesay scores were similar between the two groups.The incidance of additonal analgesics and nausea and vomiting in the group A were signifi-cantly lower than that in the group B（P〈0.05）.There was no significant difference in the awaking time of anesthesia,SBP,HR and in-cidence of adverse events between the two groups.Conclusion Preemptive analgesia with flurbiprofen can provide satisfactory pain re-lief with no obvious side effects in gynecological laparoscopic surgery,which also does not affect the awakening time,thus can provide high safety for patients.