三种不同非甾体类抗炎药对妇科腔镜术后疼痛及细胞因子的影响  

Effects of different NSAIDS on postoperative analgesia and cytokines after gynecological laparoscopic surgery

作　　者：郭一闽[1] 陈亚迟[1] 王忱[1] 

机构地区：[1]福建医科大学教学医院厦门市第二医院麻醉科,厦门市361021

出　　处：《临床麻醉学杂志》2011年第2期123-125,共3页Journal of Clinical Anesthesiology

基　　金：厦门市第二医院青年基金项目资助(YQN2009002)

摘　　要：目的观察三种不同非甾体类抗炎药(NSAIDs)用于妇科腔镜术后超前镇痛的效果及其对细胞因子的影响。方法择期行妇科腔镜手术患者240例,随机分为酮咯酸镇痛组(K组)、氟比洛芬酯镇痛组(F组)、氯诺昔康镇痛组(L组)和对照组(C组)。于麻醉后手术开始前15min分别给予酮咯酸30mg、氟比洛芬酯50mg、氯诺昔康16mg。评估术后4、8、12、24h的疼痛程度(VAS评分)及舒适度(BCS评级),于术前、术毕、术后12、24h检测白细胞介素-6(IL-6)、白细胞介素-10(IL-10)。结果术后8、12hF、L组VAS评分明显低于K、C组(P<0.05),BCS明显高于K、C组(P<0.05)。术毕、术后12hF、L组IL-6明显低于K、C组(P<0.05);术后12hF、L组IL-10明显高于K、C组(P<0.05)。结论三种NSAIDs用于妇科腹腔镜术后镇痛均有一定效果,其中以氯诺昔康组在镇痛效果、平衡细胞因子方面的个体差异最小,有利于减轻围术期应激反应。Objective To observe the effects of different non-steroidal anti inflammatory drugs （NSAIDs） on stress response and postoperative analgesia in patients undergoing gynecological laparoscopy. Methods Two hundreds and forty ASA Ⅰ or Ⅱ gynecological patients were randomized into four groups （group K, F, L, and C）. They were received 30 nag ketorolac, 50 mg flurbiprofen axetil, 16 mg lornoxicam or saline 15 min before the beginning of surgery. Visual analog score （VAS） and Bruggrmann comfortable score （BCS） were assessed 4, 8, 12 and 24 hours after surgery. The levels of Interleukin-6,10（IL-6,IL-10） were estimated before surgery, at the end of surgery, 12 and 24 hours after surgery. Results The VAS scores of group F and L were significantly lower than those of group K and C（P〈0.05）. The levels of IL-6 in group F and L were significant lower than those in group K and C at the end of surgery and 12 hours after surgery（P〈0.05）. The levels of IL-10 at 12 hours after surgery were higher than those of K and C（P〈0.05）. Conclusion Preemptive analgesia with Lornoxicam, ketorolac, flurbiprofen axetil in gynecological patients undergoing laparoscopy provides a satisfactory analgesia and relieved cytokines response, especially for Lornoxicam.

关 键 词：镇痛 非甾体类抗炎药 细胞因子 

分 类 号：R969[医药卫生—药理学]