国际麻醉学与复苏杂志   2020, Issue (12): 0-0
    
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
许丹阳, 齐向欣, 李敏, 王新辉, 张琳, 马新宇, 陈雪梅1()
1.内蒙古赤峰学院附属医院麻醉科
Efficacy of flurbiprofen axetil combined with dezocine at postoperative hyperalgesia in nicotine high-dependence patients undergoing laparoscopic surgery
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摘要:

【摘要】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:择期全麻腹腔镜胆囊切除的高度尼古丁依赖男性患者100例,ASAⅠ-Ⅱ级,随机分为4组(n=25):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和氟比洛芬酯l mg/kg。评估入恢复室(PACU)即刻(T1)、15min(T2)、离开PACU(T3)、术后24h(T4)的视觉模拟评分(VAS)和布氏舒适评分(BCS),记录手术时间和麻醉时间、苏醒时间、气管导管拔除时间、恢复室停留时间、补救镇痛、恶心呕吐、嗜睡的发生率。结果:四组一般情况、手术时间、麻醉时间、苏醒时间和拔管时间、PACU时间比较差异无统计学意义(P>0.05);VAS评分比较:T1、T2和 T4时 C组明显高于D组、F组和DF组,T3时C组高于F组和DF组,差异有统计学意义(P<0.05),DF组VAS低于D组、F组,差异有统计学意义(P<0.05)。各时间点,C组BCS评分明显低于其余三组,差异有统计学意义(P<0.05),与DF组比较,T4时BCS评分高于D组、F组,差异有统计学意义(P<0.05)。与C组比较,D组嗜睡发生率增高,D组、F组和DF组补救镇痛比例减低,差异有统计学意义(P<0.05)。与DF组相比,D组嗜睡率增高,F组补救镇痛率增高(P<0.05)。四组患者术后恶心呕吐无明显差异。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疼痛效果更好,提高了患者舒适度和满意度。

关键词: 氟比洛芬酯;地佐辛;高度尼古丁依赖;腹腔镜;术后疼痛
Abstract:

【Abstract】 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 underwent elective laparoscopic cholecystectom , ASA I or II , were randomly divided into 4 groups(n= 25 each): control group(group C) ; flurbiprofen axetil group(group F) ; 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, and flurbiprofen axetil 1 mg/kg plus dezocine 0.1 mg/kg were injected intravenously in D, F and DF groups respectively, while the equal volume of normal saline was given in group C. Assessment the visual analog score (VAS), Bruggrmarm comfort score (BCS) at postanesthesia care unit (PACU) immediately(T1) .15 min (T2). leave PACU(T3) and postoperative 24h(T4) .The operation time, anesthesia time, wake up time, extubation time, PACU time, using rate of remedial measures and nausea and vomiting were recorded. Results There were no statistical differences operation time, anesthesia time, wake up time, extubation time, PACU time between 4 groups (P>0.05). The VAS at T1, T2 and T4 in group C was significantly higher than group D,group F, group DF; group C in T3 was higher than groupF and group DF, there were statistical differences (P<0.05). The VAS in group DF was lower than group D and group F, there were statistical differences (P<0.05). The BCS was lower in group C than other three group at whole time , there were statistical differences (P<0.05). The BCS in group DF was higher than group D and group F at T4 , there were statistical differences (P<0.05). Compare with group C, the drowsiness was highest in group D, the remedial measures were lower in group D, group F and group DF, there were statistical differences (P<0.05) .Compare with group DF , the drowsiness was higher in group D ,the remedial measures was higher in group F, there were statistical differences (P<0.05).There was no significant difference in postoperative nausea and vomiting among the four groups. Conclusions The combination of flurbiprofen axetil and dizocine has a better effect on postoperative pain in patients with high nicotine dependence and improves patient comfort and satisfaction.

Key words: Flurbiprofen axetil; Dizocine; nicotine high-dependence; postoperative hyperalgesia; Laparoscopic surgery