多模式术后镇痛在腹腔镜结肠手术中的应用  

Multi-model Postoperative Analgesia Use in Laparoscopic Colon Surgery

作　　者：张延钧[1] 刘洁[1] 郑鑫[1] 王洋[1] 刘畅[1] 

机构地区：[1]大连医科大学附属第二医院,辽宁大连116027

出　　处：《现代生物医学进展》2014年第10期1926-1928,共3页Progress in Modern Biomedicine

摘　　要：目的:理论上联合使用不同机制镇痛药较镇痛药单独使用镇痛效果更完善,在妇科、骨科等手术中已有结论;笔者观察比较腹腔镜结肠手术术使用单一止痛药及联合使用不同机制镇痛药在术后镇痛的效果以及各自不良反应的发生率。方法:择期腹腔镜结肠手术患者90例,随机分为3组,每组30例。A组使用地佐辛+氟比洛酚酯行术后镇痛为多模式镇痛组;B组使用地佐辛行术后镇痛;C组使用氟比洛酚酯行术后镇痛。记录每组术后4、8、12、24 h视觉模糊评分(VAS)及术后不良反应包括嗜睡、躁动、恶心呕吐的发生率。结果:A组术后4 h、8 h的VAS评分低于B、C两组,差异有显著性,A组无嗜睡及躁动发生,发生呕吐1例,不良反应发生率A组低于B、C两组,差异有显著性。结论:地佐辛+氟比洛酚酯联合用药可安全有效应用于腹腔镜结肠手术术后镇痛,是一种有效的多模式术后镇痛方式,在减弱疼痛的放大效应及对中枢神经的作用两方面起效,因而较单独使用地佐辛及氟比洛酚酯有更好的镇痛效果,且不良反应低于单独使用地佐辛及氟比洛酚酯。Objective： In theory combined different mechanism of analgesic drugs have perfect analgesic effect compared with si- ngle use of analgesic drug. The method is called multi-model postoperative analgesia and the conclusion has got that use in gynecological surgery, orthopedics surgery laparoscopic cholecystectomy the method had satisfied effect with less adverse effect. To investigate if multi-model postoperative analgesia can be used in laparoscopic colon surgery can have better effect compare with use single analgesia drug and obse^e the rate of adverse effect while use these drugs in different groups. The aim of multi-model postoperative analgesia is block the different stages of postoperative pain, as start stage, transfer and function of central nervous. Non-steroidal anti-inflammatory drugs are fundmental drug can effectively block the pain of amplification process, so it can reduce pain generation at source, and can reduce the dosage of opiates also; new type of opioid receptor agonist can significantly reduce the central nervous sensitivity to pain, that means make pain can＇t transfer to target organs; combine two kinds of analgesic drugs mentioned above is the clinical commonly used method can gain perfect analgesic effect. Methods： 90 patients undergoing elective surgery, were randomly divided into the three groups with 30 cases in each group. In group A use dezoxine combine flurbiprofen axetil, in group B use dezoxine for postoperative analgesia drug while use flubiprofen axetil for postoperative analgesia drug in C group. Record VAS score of postoperative for 4, 8,12,24 h in the three groups and the rate of adverse effect in the three groups. Results： 8 hour after surgery VAS score in group A was3.5± 0.4, group A VAS score below than B, C group, with significant difference, adverse reactions in group A less than B, C group, significant difference. Conclusion： Dezocine combine with flurbiprofen axetil use in laparoscopic rectal surgery for postoperative analgesia can both Block the pain of amp

关 键 词：多模式 术后镇痛 腹腔镜 结肠手术 

分 类 号：R614[医药卫生—麻醉学]