氟比洛芬酯静脉滴注与罗哌卡因切口局部浸润在腹腔镜胆囊切除术后镇痛的应用效果对比

Comparison of analgesia effect of intravenous drip of flurbiprofen axetil with that of local incision infiltration of ropivacaine after laparoscopic cholecystectomy

目的对比氟比洛芬酯静脉滴注与罗哌卡因切口局部浸润在腹腔镜胆囊切除术后的镇痛效果。方法选取2019年1月至2020年1月于我院行腹腔镜胆囊切除术患者60例,根据入院时间先后依次将其分为A组(31例)和B组(29例),A组于手术结束前5 min采取氟比洛芬酯静脉滴注进行镇痛,B组于手术结束时采取罗哌卡因切口局部浸润进行镇痛,比较两组患者术后不同时间点疼痛程度、术后指标以及术后24 h内使用镇痛药的比例。结果在术后1 h和12 h,两组患者疼痛评分比较差异无统计学意义(P>0.05),但在术后2 h和6 h,B组患者疼痛评分明显低于A组(P<0.05)。B组患者发生恶心呕吐不良反应的比例以及下床时间明显少于A组(P<0.05),另外,两组患者排气时间、住院时间比较,差异均无统计学意义(P>0.05)。术后6 h,B组患者中使用镇痛药的比例明显低于A组(P<0.05);术后12 h,A组患者使用镇痛药的比例显著下降,两组使用镇痛药比例差异无统计学意义(P>0.05)。术后24 h,除A组有1例需镇痛药外,其余均不需要镇痛药(P>0.05)。结论罗哌卡因切口局部浸润麻醉对腹腔镜胆囊切除患者术后镇痛效果更好,不良反应发生率低,在临床上值得推广应用。

Objective To compare the analgesia effect of intravenous drip of flurbiprofen axetil with that of local incision infiltration of ropivacaine incision after laparoscopic cholecystectomy.Methods Sixty patients who underwent laparoscopic cholecystectomy in our hospital from January 2019 to January 2020 were enrolled.According to the admission time,they were divided into group A(31 cases)and group B(29 cases).At 5 min before the end of surgery,group A was given intravenous drip of flurbiprofen axetil for analgesia,while group B was given local incision infiltration of ropivacaine for analgesia at the end of surgery.The pain degree at different time points after surgery,postoperative indexes and the proportion of analgesics use within 24 h after surgery were compared between the two groups.Results There was no significant difference in pain score between the two groups at 1 h and 12 h after surgery(P>0.05).At 2 h and 6 h after surgery,pain score in group B was significantly lower than that in group A(P<0.05).The proportion of adverse reactions such as nausea and vomiting,and off-bed time in group B were significantly lower than those in group A(P<0.05).In addition,there was no significant difference in exhaust time or hospitalization time between the two groups(P>0.05).At 6 h after surgery,the proportion of analgesics use in group B was significantly lower than that in group A(P<0.05).At 12 h after surgery,the proportion of analgesics use in group A was significantly decreased.There was no significant difference in the proportion of analgesics use between the two groups(P>0.05).At 24 h after surgery,only one case in group A needed analgesics(P>0.05)in both groups.Conclusion The analgesic effect of local incision infiltration anesthesia of ropivacaine is better for patients undergoing laparoscopic cholecystectomy,with low incidence of adverse reactions.