地佐辛联合氟比洛芬酯对妇科肿瘤手术患者镇静、镇痛及血浆炎症细胞因子水平的影响

Effects of dezocine and flurbiprofen axetil on sedation,analgesia and plasma inflammatory cytokines in patients undergoing gynecological tumor surgery

目的探讨地佐辛联合氟比洛芬酯术后镇痛对妇科肿瘤手术患者镇静、镇痛及血浆炎症细胞因子水平的影响。方法按照随机数字表法将156例择期行妇科肿瘤手术的患者分为芬太尼组(F组)和地佐辛联合氟比洛芬酯组(DF组),每组78例。两组患者术毕清醒后均行静脉自控镇痛,F组的镇痛泵配方为芬太尼,DF组的镇痛泵配方为地佐辛联合氟比洛芬酯。比较两组患者的术后不良反应发生情况及术后不同时刻[麻醉诱导前(T0)、术后2 h(T1)、术后24 h(T2)、术后48 h(T3)、术后72 h(T4)]的镇痛、镇静评分及血浆炎症细胞因子水平。结果DF组患者恶心、呕吐的发生率均明显低于F组(P﹤0.01)。两组患者术后T0~4时刻的Ramsay镇静评分和视觉模拟评分量表(VAS)评分比较,差异均有统计学意义(P﹤0.01);两组患者的Ramsay镇静评分组间比较,差异有统计学意义(P﹤0.01)。两组患者的VAS评分组间比较,差异无统计学意义(P﹥0.05);两组患者的Ramsay镇静评分和VAS评分在时间和组别上存在交互作用(P﹤0.01)。两组患者术后T0~4时刻的肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平比较,差异均有统计学意义(P﹤0.01);两组患者的TNF-α和IL-6水平组间比较,差异均有统计学意义(P﹤0.01);两组患者的TNF-α和IL-6水平在时间和组别上存在交互作用(P﹤0.01)。结论与芬太尼比较,地佐辛联合氟比洛芬酯的术后镇痛效果满意,且不良反应少,有利于缓解妇科肿瘤手术患者术后的炎症状态。

Objective To investigate the effects of postoperative analgesia with dezocine combined with flurbiprofen axetil on sedation,analgesia and plasma inflammatory cytokines in patients undergoing gynecological tumor surgery.Method Totally,156 patients receiving elective gynecological tumor surgery were randomized as per a random number table as fentanyl group(F group)or dezocine plus flurbiprofen axetil group(DF group),with 78 cases in each.Patients in either group were administered with intravenous self-controlled analgesia after waking up,the fentanyl was prescribed for the analgesic pump in F group,compared with dezocine plus flurbiprofen axetil in DF group.The incidence of adverse reactions were compared between the two groups,furthermore,at different time points after surgery[before induction of anesthesia(T0),2 h after surgery(T1),24 h after surgery(T2),48 h after surgery(T3),and 72 h after surgery(T4)],the scores of analgesia and sedation as well as plasma inflammatory cytokines were assessed.Result The incidence rates of nausea and vomiting in the DF group were significantly less than those in the F group(P<0.01),and the Ramsay sedation scores and visual analogue scale(VAS)scores at T0~4 post surgery differed significantly(P<0.01);significant difference was noted for intergroup Ramsay sedation scores(P<0.01);while the VAS scores were similar between the two groups(P>0.05);time-group interactions were noted for the Ramsay sedation scores and VAS scores between the two groups of patients(P<0.01).The tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels of the two groups at T0-4 were of statistically significant difference(P<0.01);significant difference was also observed for the TNF-αand IL-6 levels between the two groups(P<0.01),interaction was seen for the TNF-αlevels in both groups in terms of time and groups(P<0.01).Conclusion Compared with fentanyl,dezocine combined with flurbiprofen axetil demonstrates acceptable analgesic effect and induces less adverse reactions,which is beneficial for relieving postoperative inflammatory state.