氟比洛芬酯联合罗哌卡因平衡镇痛用于妇科腹腔镜术后镇痛的效果分析  

Effects of flurbiprofen axetil combined with ropivacaine for balance analgesia after laparoscopic gynecologic surgery

作　　者：王苑[1] 安小虎[1] 徐韬[1] 余大松[1] 

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院麻醉科,上海200030

出　　处：《同济大学学报（医学版）》2013年第6期110-113,共4页Journal of Tongji University(Medical Science)

摘　　要：目的观察氟比洛芬酯联合罗哌卡因平衡镇痛用于妇科腹腔镜术后镇痛的效果。方法择期行妇科腹腔镜手术的患者共150例ASAⅠ-Ⅱ级，随机均分为三组，A组为氟比洛芬酯和罗哌卡因联合用药组（n=50例），B组为罗哌卡因组（n=50例），C组为对照组（n=50例）。A组患者麻醉诱导前15min静脉注射氟比洛芬酯50mg，在腹壁打孔前用0．375％罗哌卡因行皮肤切口浸润麻醉．各3ml，手术结束前于腹腔内喷洒0．375％罗哌卡因30ml。B组仅用罗哌卡因局部浸润和腹腔内局麻药喷洒，方法同A组。C组不用额外镇痛方法。用视觉模拟评分法（VAS）观察术后1、4、8、12、24h的切口痛（皮肤感觉痛）、内脏痛（如主诉有大小便欲望，胃痛等），并记录各组术后需要使用镇痛药（哌替啶）的时间、人数和使用的次数。结果A组在术后l、4、8、12h点2个部位疼痛VAS评分均显著低于C组（P〈0．05）；A组和B组比较，只在术后4h和8h时切口VAS评分低于B组（P〈0．05）；B组和C组比较，在术后1、4、8h时，2处VAS评分均显著低于c组（P〈0．05）。A组和B组初次使用哌替啶时间、人数和使用次数均显著低于C组，A组的使用人数和次数显著低于B组（P〈0．05）。术后未观察到与镇痛相关的术后出血、局麻药中毒等副作用。结论氟比洛芬酯联合罗哌卡因平衡镇痛用于妇科腹腔镜术后镇痛有很好的效果。Objective To assess the effects of flurbiprofen axetil combined with ropivacaine for balance analgesia after laparoscopy gynecological surgery. Methods One hundred and fifty patients with ASA I -II, undergoing selective gynecological laparoscopic operation, were randomly assigned to group A （flurbiprofen axetil combined with ropivacaine, n = 50 ）, group B （ropivacaine, n = 50 ） and group C （control, n = 50）. In group A, 15min before induction of anesthesia, patients were injected intravenously with flurbiprofen axetil 50 rag, before the abdominal wall perforation, 0. 375 % ropivacaine was used for skin infiltration anesthesia, and before the end of surgery, intraperitoneal spraying with 0. 375% ropivacaine 30 ml. In group B patients received ropivacaine local infiltration and intraperitoneal local anesthetic spray, as in group A. In group C patients had no additional analgesia agents. Visual analogue score （VAS） was observed for incision pain, visceral pain at 1,4, 8, 12, 24 h after surgery, and the time and frequency of postoperative pethidine use were documented. Results VAS score in two sites in group A at 1, 4, 8, 12 h after operation was significantly lower than that in group C （ P 〈 0.05 ）. The VAS score of incision pain in group A was lower than that in group B at 4 and 8 h after operation （ P 〈 0.05 ）. The VAS scores of two sites pain in group B were significantly lower than that in group C at 1, 4 and 8 h after surgery （ P 〈 0.05 ）. The times and frequency of pethidine use in groups A and B were significantly lower than those in group C, the rate and frequency of pethidine use in group A were lower than those in group B （ P 〈 0.05 ）. The side effects related to analgesia, including postoperative bleeding and toxicosis of local anesthetics were not observed after surgery. Conclusion The analgesic effect of flurbiprofen axetil combined with ropivacaine for balance analgesia is satisfactory for patients after gynecological laparoscopy.

关 键 词：氟比洛芬酯 罗哌卡因 平衡镇痛 妇科腹腔镜手术 

分 类 号：R614.2[医药卫生—麻醉学]