布洛芬与洛索洛芬钠在阻生齿拔除超前镇痛中的应用效果比较

Comparison of the application effects of ibuprofen and loxoprofen sodium in preemptive analgesia for impacted tooth extraction

目的对比阻生齿拔除超前镇痛中布洛芬与洛索洛芬钠的应用效果。方法选择2020年10月—2023年10月于本院行阻生齿拔除的患者126例作为研究对象,随机数表法分为洛索洛芬钠组和布洛芬组两组,每组各63例。术前15 min洛索洛芬钠组口服洛索洛芬钠片60 mg,布洛芬组口服布洛芬片0.4 g。比较两组麻醉起效时间、手术时间;比较两组术前、手术10 min、术后30 min平均动脉压(MAP)、心率(HR);比较两组手术10 min、术后即刻、术后30 min、术后2 h、术后4 h疼痛情况;比较两组术后0~6 h、>6~12 h、>12~24 h镇痛药追加率;比较两组不良反应。结果两组麻醉起效时间、手术时间比较,差异均无统计学意义(P>0.05);重复测量方差分析显示,两组MAP、HR组间、时间、交互效应上差异均有统计学意义(P<0.05);组间:术前、术后30 min两组平均动脉压、心率比较,差异无统计学意义(P>0.05),洛索洛芬钠组手术10 min平均动脉压、心率均低于布洛芬组(P<0.05);组内:两组手术10 min平均动脉压、心率均高于术前(P<0.05),术后30 min平均动脉压、心率均低于手术10 min(P<0.05),术前、术后30 min平均动脉压、心率比较,差异无统计学意义(P>0.05);重复测量方差分析显示,两组疼痛视觉模拟量表(VAS)评分组间、时间、交互效应上差异均有统计学意义(P<0.05);组间:洛索洛芬钠组手术10 min、术后即刻、术后30 min、术后2 h、术后4 h VAS评分均低于布洛芬组(P<0.05)。组内:两组术后即刻、术后30 min、术后2 h、术后4 h VAS评分均高于手术10 min(P<0.05);两组术后30 min、术后2 h、术后4 h VAS评分均高于术后即刻(P<0.05);两组术后2 h、术后4 h VAS评分均高于术后30 min(P<0.05);两组术后4 h VAS评分均低于术后2 h(P<0.05);两组术后0~6 h镇痛药追加率比较,差异均无统计学意义(P>0.05);洛索洛芬钠组术后>6~12 h、>12~24 h镇痛药追加率均低于布洛芬组(P<0.05);洛索洛芬钠组不良反应发生率低于布洛芬组(P<0.05)。结论相较于布洛芬,洛索洛芬钠在阻生齿拔除超前镇痛中效果更好,对手术10 min血流动力学的影响更小,术后疼痛更轻,且不良反应更少。

Objective To compare the application effects of ibuprofen and loxoprofen sodium in preemptive analgesia for impacted tooth extraction.Methods One hundred and twenty-six patients who underwent impacted tooth extraction in our hospital from October 2020 to October 2023 were selected as study subjects,and they were randomly divided into loxoprofen sodium group and ibuprofen group according to computer random number table method,with 63 cases in each group.The loxoprofen sodium group took 60 mg of loxoprofen sodium tablets orally 15 minutes before the operation,and the ibuprofen group took 0.4 g of ibuprofen tablets orally.The anesthesia onset time and operation time of the two groups were compared.The mean arterial pressure(MAP)and heart rate(HR)of two groups before surgery,10 min after surgery,and 30 min after surgery were compared.The pain status of two groups at 10 min of surgery,immediately after surgery,30 min after surgery,2 h after surgery,and 4 h after surgery were compared.The analgesic drug supplementation rate of two groups at 0~6 h after surgery,6~12 h after surgery,and 12~24 h after surgery were compared.The adverse reactions of the two groups were compared.Results There were no significant differences in the anesthesia onset time and surgery time between the two groups(P>0.05).Repeated measures analysis of variance showed that there were significant differences in MAP and HR at aspects of inter-group,time,and interaction effects(P<0.05).Between groups:there were no significant differences in MAP and HR between the two groups before surgery and,30 min after surgery(P>0.05);the MAP and HR of the loxoprofen sodium group were lower than those of the ibuprofen group at 10 min during surgery(P<0.05).Within groups:the MAP and HR of both groups were higher than those before surgery at 10 min during surgery(P<0.05);MAP and HR at 30 min after surgery were lower than those at 10 min during surgery(P<0.05);there were no significant differences in MAP and HR between before surgery and 30 min after surgery(P>0.05).Repeated measures analysis of variance showed that there were significant differences in the visual analogue scale(VAS)scores at aspects of inter-group,time,and interaction effects(P<0.05).Between groups:the VAS scores of the loxoprofen sodium group were lower than those of the ibuprofen group at 10 min during surgery,immediately after surgery,30 min after surgery,2 h after surgery,and 4 h after surgery(P<0.05).Within groups:the VAS scores of both groups were higher than those at 10 min during surgery at time points immediately after surgery,30 min after surgery,2 h after surgery,and 4 h after surgery(P<0.05);the VAS scores of both groups at 30 min after surgery,2 h after surgery,and 4 h after surgery were higher than those at immediately after surgery(P<0.05);The VAS scores of both groups at 2 h after surgery and 4 h after surgery were higher than those at 30 min after surgery(P<0.05);The VAS scores of both groups at 4 h after surgery were lower than those at 2 h after surgery(P<0.05).There was no significant difference in the analgesic drug supplementation rate between the two groups at 0~6 h after surgery(P>0.05).The analgesic drug supplementation rate of the loxoprofen sodium group were lower than those of the ibuprofen group at 6~12 h after surgery and 12~24 h after surgery(P<0.05).The adverse reaction rate of the loxoprofen sodium group was lower than that of the ibuprofen group(P<0.05).Conclusions Compared with ibuprofen,loxoprofen sodium has a better effect in preemptive analgesia for impacted tooth extraction,has a smaller impact on hemodynamics at 10 min during surgery,causes less pain after surgery,and induces fewer adverse reactions.