氟比洛芬酯复合地佐辛对高度尼古丁依赖患者腹腔镜术后疼痛的影响

Efficacy of flurbiprofen axetil combined with dezocine at postoperative hyperalgesia in nicotine high⁃dependence patients un⁃dergoing laparoscopic surgery

目的探讨氟比洛芬酯复合地佐辛对高度尼古丁依赖患者术后疼痛的影响。方法择期全身麻醉腹腔镜胆囊切除的高度尼古丁依赖男性患者100例,ASA分级Ⅰ、Ⅱ级,采用随机数字表法将患者分为4组(每组25例):对照组(C组)、地佐辛组(D组)、氟比洛芬酯组(F组)、地佐辛+氟比洛芬酯组(DF组)。麻醉诱导前,C组给予等容量生理盐水,D组静脉注射地佐辛0.2 mg/kg,F组静脉注射氟比洛芬酯2 mg/kg,DF组静脉注射地佐辛0.1 mg/kg+氟比洛芬酯l mg/kg。评估入PACU即刻(T1)、入PACU 15 min(T2)、离开PACU(T3)、术后24 h(T4)的VAS评分和布氏舒适评分(Bruggrmann Comfort Scale,BCS),记录各组患者手术时间、麻醉时间、苏醒时间、拔管时间、PACU停留时间,术后各时点VAS与BCS评分,术后补救地佐辛、恶心呕吐、嗜睡的发生率。结果4组患者手术时间、麻醉时间、苏醒时间、拔管时间、PACU停留时间比较,差异无统计学意义(P>0.05)。C组T1、T2、T4时VAS评分高于D组、F组和DF组(P<0.05)。C组T3时VAS评分高于F组和DF组(P<0.05)。DF组T4时VAS评分低于D组和F组(P<0.05)。C组各时点BCS评分均低于D组、F组和DF组(P<0.05),DF组T4时BCS评分高于D组和F组(P<0.05)。C组术后补救地佐辛发生率高于D组、F组和DF组(P<0.05),F组术后补救地佐辛发生率高于DF组(P<0.05)。D组嗜睡发生率高于C组和DF组(P<0.05)。4组患者术后恶心、呕吐发生率比较,差异无统计学意义(P>0.05)。结论氟比洛芬酯和地佐辛联合应用对尼古丁高度依赖患者腹腔镜术后镇痛效果更好,提高了患者舒适度和满意度。

Objective To investigate the effects of flurbiprofen axetil combined with dezocine on postoperative hyperalgesia in the nicotine high‑dependence patients after laparoscopic surgery.Methods One hundred nicotine high‑dependence patients undergo‑ing elective laparoscopic cholecystectomy,American Society of Anesthesiologists(ASA)ⅠorⅡ,were divided into 4 groups by random number table method(n=25):control group(group C),flurbiprofen axetil group(group F),and dezocine group(group D),flurbiprofen axetil plus dezocine group(group DF).Before induction of anesthesia,dezocine 0.2 mg/kg,flurbiprofen axetil 2 mg/kg,or flurbiprofen axetil 1 mg/kg plus dezocine 0.1 mg/kg were injected intravenously in groups D,F and DF respectively,while the equal volume of normal saline was given in group C.Visual Analogue Scale(VAS)and Bruggrmann Comfort Scale(BCS)were evaluated immediately after enter‑ing post‑anesthesia care unit(PACU,T1),entering PACU 15 min(T2),leaving PACU(T3)and 24 h after operation(T4).The operation time,anesthesia time,recovery time,extubation time,the length of PACU stay,VAS and BCS scores at each time point after operation,and the incidence of postoperative dezocine,nausea,vomiting and drowsiness were recorded.Results There were no statistical differences in the operation time,anesthesia time,wake up time,extubation time,and length of PACU stay among the 4 groups(P>0.05).The VAS score in group C was significantly higher than that in group D,group F,and group DF at T1 and T2(P<0.05).The VAS score in group C was high‑er than that in group F and group DF at T3(P<0.05).The VAS score in group C was higher than that in group D,group F and group DF at T4(P<0.05).The VAS score in group DF was lower than that in group D and group F(P<0.05).The BCS score was lower in group C than in other three groups at each time point(P<0.05).The BCS score in group DF was higher than that in group D and group F at T4(P<0.05).The incidence of postoperative remedial dezocine in group C was higher than that in group D,group F and group DF(P<0.05),and the in‑cidence of postoperative remedial dezocine in group F was higher than that in group DF(P<0.05).The incidence of drowsiniss in group D was higher than that in group C and group DF(P<0.05).There was no significant difference in the incidence of postoperative nausea and vomiting among the 4 groups(P>0.05).Conclusions The combination of flurbiprofen axetil and dezocine has a better effect on postoperative pain in patients with nicotine high‑dependence and can improve patient comfort and satisfaction.