氟比洛芬酯超前镇痛用于腹腔镜保胆取石术的临床疗效分析  

Flurbiprofen axetil preemptive analgesia for patients undergoing laparoscopic cholecystotomy:a clinical observation

作　　者：黄安宁[1] 刘丽萍[1] 陈娜[1] 丁莉莉[1] 胡彬[1] 

机构地区：[1]武警北京总队医院麻醉科,北京100027

出　　处：《第二军医大学学报》2015年第3期338-341,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨静脉注射氟比洛芬酯用于腹腔镜保胆取石手术患者超前镇痛的临床效果和安全性。方法腹腔镜保胆取石手术患者60例,ASAⅠ-Ⅱ级,随机分为实验组（F组）和对照组（C组,n=30）：F组手术开始前静脉滴注氟比洛芬酯100mg,C组术前静脉滴注生理盐水溶液10 mL,术毕均采用芬太尼经静脉患者自控镇痛（patient controlled intravenous analgesia,PCIA）,记录术毕至拔出喉罩所用时间,评定苏醒躁动程度（SAS）、恢复室停留时间、术后芬太尼用量以及拔出喉罩即刻及术后2、4、6、12、24h的视觉模拟疼痛评分（visual analogue scale,VAS）,并观察恶心、呕吐等不良反应的发生率。结果术毕F组SAS、拔出喉罩即刻及术后各时点VAS评分均低于C组,差异有统计学意义（P〈0.05）;C组术后芬太尼用量较F组增加,且恶心、呕吐发生率更高（P〈0.05）;两组拔管时间及恢复室停留时间差异无统计学意义。结论氟比洛芬酯超前镇痛可减轻腹腔镜保胆取石术术后急性疼痛,镇痛效果确切,不良反应少,且不增加患者恢复室停留时间,值得临床推广。Objective To investigate the effect and safety of flurbiprofen axetil preemptive analgesia for patients undergoing laparoscopic cholecystotomy. Methods Sixty patients of ASA Ⅰ-Ⅱ undergoing selective laparoseopic cholecystotomy were randomly assigned to two groups., either to receive flurbiprofen axetil 100 mg （flurbiprofen axetil group, n=30）or normal saline 10 mL （control group, n=30） before operation. Postoperative pain was treated by patient-controlled intravenous fentanyl analgesia. The extubation time, recovery time, and sedation-agitation scale （SAS） scores were estimated immediately after anesthesia. Postoperative fentanyl doses, side effects and the visual analgesia scale scores were recorded at 0,2,4, 6, 12, and 24 h after operation. Results The SAS score, VAS scores immediately after extubation and at different time points after operation in flurbiprofen axetil group were significantly lower than those in control group （P〈0. 05）. The flurbiprofen axetil group had significantly lower total dose of fentanyl （0-24 h after surgery） and significantly less nausea and vomiting than the control group （P〈0. 05）. There were no significant differences in the extubation time and recovery time between the two groups. Conclusion Flurbiprofen axetil preemptive analgesia can alleviate acute postoperative pain of laparoscopic choleeystotomy, with no obvious adverse effect and without increasing the recovery time, making it worth popularizing in clinical practice.

关 键 词：氟比洛芬 腹腔镜检查 保胆取石术 手术后疼痛 

分 类 号：R657.42[医药卫生—外科学]