氟比洛芬酯超前镇痛对腹腔镜胆囊切除术全麻苏醒拔管时患者应激反应的影响  

Effect of Preemptive Analgesia with Flurbiprofen on Stress Reaction in Patients Undergoing Lapa-roscopic Cholecystectomy

作　　者：潘霞云[1] 孟哲贤[2] 

机构地区：[1]湖南省常德市第一人民医院药剂科,湖南常德415000 [2]湖南省常德市第一人民医院麻醉科,湖南常德415000

出　　处：《医学临床研究》2011年第5期933-934,937,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜胆囊切除手术（LC）围术期应用氟比洛芬酯超前镇痛对气管拔管时应激反应的影响。【方法】择期LC手术患者50例，随机分为氟比洛芬酯超前镇痛治疗组（F组，n=25）和对照治疗组（C组，n=25）。手术开始前20min开始使用氟比洛芬酯或等容量生理盐水。比较给药前（T。）、拔管时（Tz）、拔管后20rain（T3）时平均动脉压、心率及血糖浓度，并比较两组拔管时间、术后并发症的情况，并于术后6h、24h行静息和运动疼痛视觉模拟评分（VAS）。【结果】两组拔管时间差异无统计学意义。两组血压和心率在Tz时升高，与T。相比有统计学意义；与C组相比，T2、T。时F组血压、心率降低（P〈0．05）。F组血糖浓度在T3时降低（P〈0．05）。F组术后躁动发生率明显降低。与C组相比，术后6h静息痛、运动痛和术后24h静息痛VAS评分降低（P〈0．05）。【结论】氟比洛芬酯超前镇痛能明显改善气管拔管时血流动力的学改变，减轻应激反应。[Objective]To explore the effect of preemptive analgesia with flurbiprofen on stress reaction in patients undergoing laparoscopic cholecystectomy（LC） when extubation. IMethods] Fifty patients scheduled for LC were random- ly divided into flurbiprofen preemptive analgesia group（group F, n= 25） and control group（group C, n =25）. Flurbipro- fen 50mg or equal volume of saline was given 20rain before the beginning of surgery. The mean arterial pressure, heart rate and blood glucose concentration were recorded and compared before administration（T1 ）, when extubation（T2 ） and 20 min after extubation（Ta ）. The time of extubation and postoperative complications were compared between two groups. The resting and moving VAS score were recorded 6h and 24h after surgery. [Results] There was no significant difference in the time of extubation between two groups. Compared with at T1, blood pressure and heart rate of two groups in- creased, and there was significant difference between T1 and T2. Compared with group C, blood pressure and heart rate in group F decreased at Tz and T3 （ P 〈0.05）. Blood glucose concentration in group F decreased at T3 （ P 〈0.05）. Com- pared with group C, the incidence rate of restlessness and the resting and moving VAS score in group F after surgery de- creased significantly（ P 〈0.05）. [Conclusion] Preemptive analgesia with flurbiprofen can obviously improve the hemody- namic change when extubation and decrease the stress reaction.

关 键 词：胆囊切除术 腹腔镜 氟比洛芬/投药和剂量 镇痛 应激 

分 类 号：R657.4[医药卫生—外科学]