国际麻醉学与复苏杂志   2015, Issue (11): 0-0
    
联合氟比洛芬酯的多模式镇痛及配伍地塞米松对妇科腹腔镜日间手术后恢复的影响
周莉莉, 汪小海1()
1.南京鼓楼医院
Effects of multimodal analgesia combined with flurbiprofen and compatibility of dexamethasone on postoperative recovery after gynecological laparoscopic day-case surgery
 全文:
摘要:

【摘要】:目的 探讨联合氟比洛芬酯的多模式镇痛及配伍地塞米松对妇科腹腔镜日间手术后恢复的影响。方法 90例全麻下行妇科腹腔镜日间手术的患者完全随机分组为3组,麻醉诱导时:A组和B组静脉注射0.1mg/kg地塞米松,C组静脉注射等容量生理盐水;麻醉诱导后:A组和C组静脉滴注1mg/kg氟比洛芬酯,B组静脉滴注等容量生理盐水。术毕均静脉注射昂丹司琼8 mg。记录患者在术后0、2、4、6和8h的视觉模拟评分(Visual analogue scale,VAS)和舒适评分(Bruggrmann comfort scale,BCS)及相关不良反应。结果 术后0、2h VAS评分A组明显低于C组(P<0.05),C组明显低于B组(P<0.05);术后4h VAS评分A组和C组明显低于B组(P<0.05);术后0、2h BCS评分A组明显高于C组(P<0.05),C组明显高于B组(P<0.05);术后4h BCS评分A组和C组明显高于B组(P<0.05)。B组术后追加镇痛药物的发生率(23%)明显高于A组(0%)和C组(10%)(P<0.05);B组和C组术后恶心呕吐(Postoperative nausea and vomiting,PONV)的发生率(27%和30%)明显高于A组(3%)(P<0.05);B组和C组延长留观时间的发生率(23%和20%)明显高于A组(3%)(P<0.05)。结论 联合氟比洛芬酯的多模式镇痛及配伍地塞米松可显著提高妇科腹腔镜日间手术患者的术后舒适度。

关键词: 【关键词】:妇科腹腔镜手术;日间手术 ;氟比洛芬酯 ;地塞米松;镇痛;术后恶心呕吐
Abstract:

Abstract: Objective To discuss the effects of multimodal analgesia combined with flurbiprofen and compatibility of dexamethasone on postoperative recovery after gynecological laparoscopic day-case surgery. Method 90 cases of patients undergoing elective gynecological laparoscopic day-case surgery were randomly divided into 3 groups,during anaesthetic induction:group A and B was given 0.1mg/kg dexamethasone by intravenous injection, but group C was given 2 ml normal saline by intravenous injection; after anaesthetic induction: group A and C was given 1mg/kg flurbiprofen plus 0.9% NaCl 100 ml by intravenous injection slowly, but group B was given normal saline by intravenous injection slowly. All groups were given 8 mg ondansetron by intravenous injection at the end of surgery. The postoperative pain of the patients at 0、2、4、6 and 8h after surgery in 3 groups,was evaluated and recorded using a visual analogue scale(VAS)and bruggrmann comfort scale(BCS).Other related adverse effects were also noted. Results VAS scores at 0, 2h after surgery was significantly lower in group A than in group C(P<0.05), group C was significantly lower than group B(P<0.05); VAS scores at 4h after surgery was significantly lower in group A and C than in group B(P<0.05); BCS scores at 0, 2h after surgery was significantly higher in group A than in group C(P<0.05), group C was significantly higher than group B(P<0.05); BCS scores at 4h after surgery was significantly higher in group A and C than in group B (P<0.05). Compared to group A(0%) and C(10%), the incidence of using postoperative analgesic drugs was significantly higher in group B(23%)(P<0.05); the incidence of postoperative nausea and vomiting (PONV)were significantly higher in group B(27%)and C(30%) than that in group A(3%)(P<0.05); the incidence of extending stay time were significantly higher in group B(23%)and C(20%)than that in group A(3%) (P<0.05).Conclusion Multimodal analgesia combined with flurbiprofen and compatibility of dexamethasone can significantly improve the comfort degree of patients after gynecologic laparoscopic day-csae surgery.

Key words: Key words: Gynecological laparoscopic operation;Day-case surgery; Flurbiprofen;Dexamethasone ;Analgesia;Post operative nausea and vomitting