氟比洛芬酯联合碳酸利多卡因盆腔冲洗及创口浸润用于腹腔镜妇科手术后镇痛

Effect of lidocaine carbonate and intravenous flurbiprofen axetil intrapelvic on irrigation and incision infiltration for postoperative pain after gynecological laparoscopy

目的比较妇科腹腔镜手术碳酸利多卡因盆腔冲洗联合创口浸润与术后静脉注射氟比洛芬酯的镇痛效果。方法择期全身麻醉下妇科腹腔镜手术患者75例，采用随机数字表法分为三组，每组25例。对照1组：手术结束静脉注射氟比洛芬酯100mg；对照2组：手术结束用0．35％碳酸利多卡因100ml冲洗盆腔，并用0．87％碳酸利多卡因10ml对腹部创口局部浸润；观察组：联合应用对照1组和对照2组的方法。记录术后1，4，8，12，24h疼痛视觉模拟评分（VAS），肛门排气时间，不良反应等。结果对照1组和观察组各有1例退出研究。观察组术后1，4，8，12，24hVAS分别为（9．5±7．9）、（14．9±8．7）、（17．2±10．3）、（12．2±7．7）、（5．3±3．8）mm，对照1组分别为（39．2±15．0）、（33．4±13．0）、（36．2±12．8）、（35．8±12．7）、（10．6±4．2）mm，对照2组分别为（26．6±13．0）、（30．2±12．0）、（33．3±13．1）、（30．4±9．8）、（9．8±4．7）mm，观察组与对照1组、对照2组比较差异有统计学意义（P〈0．05）。三组肛门排气时间、不良反应发生率比较差异无统计学意义（P〉0．05）。结论妇科腹腔镜手术后碳酸利多卡因盆腔冲洗联合创口局部浸润与术后静脉注射氟比洛芬酯较单独应用明显减轻了患者术后疼痛程度，减少了术后镇痛药的使用。

Objective To compare the analgesia effect of lidocaine carbonate combined with intravenous flurbiprofen axetil with intravenous flurbiprofen axetil on intrapelvic irrigation and incision infiltration after gynecological laparoseopy. Methods Seventy-five patients scheduled for gynecological laparoscopy under general anesthesia were divided into 3 groups by random number table method with 25 cases each. Patients in control group 1 received intravenous flurbiprofen axetil 100 mg after surgery; patients in control group 2 received intrapelvic irrigation with 0.35% lidocaine carbonate 100 ml, and incision infiltration with 0.87% lidoeaine carbonate t0 ml respectively after surgery; patients in observation group received the combination of control group 1 and control group 2. The visual analogue scores （VAS） at 1, 4, 8, 12 and 24 h after surgery, time of passage of gas by anus and untoward reaction were recorded. Results One case in control group 1 and 1 case in observation group withdrew from the study. The VAS at 1, 4, 8, 12 and 24 h in observation group were （9.5± 7.9）, （14.9 ±8.7）, （17.2 ±10.3）, （12.2 ±7.7）, （5.3 ± 3.8） mm, in control group 1 were （39.2 ±15.0）, （33.4 ± 13.0）, （36.2 ±12.8）, （35.8 ±12.7）, （10.6 ±4.2） mm, and in control group 2 were （26.6±13.0）, （30.2 ± 12.0）, （33.3 ± 13.1）, （30.4 ± 9.8）, （9.8 ±4.7） mm. And there were statistical differences between observation group and control group 1, 2 （P 〈 0.05）. There were no statistical differences in time of passage of gas by anus and untoward reaction incidence in the 3 groups （P 〉 0.05）. Conclusion Intrapelvic irrigation and incision infiltration with fidoeaine carbonate and intravenous flurbiprofen axetil compared with intravenous flurbiprofen axetil alone after gynecological laparoseopy can significantly reduce the pain intensity and analgesia requirement, without increasing the untoward reaction incidence.