氟比洛芬酯用于腹腔镜胆囊切除术多模式镇痛的临床观察.docVIP

氟比洛芬酯用于腹腔镜胆囊切除术多模式镇痛的临床观察 马晨光 吴秀英 （中国医科大学附属盛京医院麻醉科 沈阳 110004） 摘要：目的 观察氟比洛芬酯联合应用曲马多用于腹腔镜胆囊切除术多模式镇痛的作用效果。方法 60例行腹腔镜胆囊切除术的患者，随机分成3组，每组20例。A组与B组术前15min静注氟比洛芬酯1mg·kg-1，C组手术结束前10min静注氟比洛芬酯1mg·kg-1;术毕A组静注生理盐水20ml，B组与C组静注曲马多1mg·kg-1。分别记录术毕给药后30min、1、2、4、8、12、24h的视觉模拟评分（VAS评分），不良反应及患者对镇痛治疗的总体满意度。结果B组切口痛、内脏痛、肩背痛VAS评分在术后24h内各时间点均低于A组和C组（P0.05）。3组术后不良反应无显著差别（P 0.05）。患者对镇痛治疗总体满意度B组与A组、与C组比较均有显著意义（P 0.05）。结论 氟比洛芬酯术前应用具有超前镇痛作用；同时联合应用曲马多，可以提高镇痛质量；是腹腔镜胆囊切除术患者术后多模式镇痛的良好选择。 关键词：氟比洛芬酯；多模式镇痛；腹腔镜胆囊切除术；曲马多 中图分类号： 文献标志码： 文章编号： Clinical study of flurbiprofen axetil on multimodal analgesia in patients undergoing laparoscopic cholecystectomy. MA Chen-guang , WU Xiu-ying Department of Anaesthesiology , Shengjing hospital affiliated to China Medical University, Shenyang 110004 ,China Abstract：Objective To assess the multimodal analgesia effect of flurbiprofen axetil with tramadol for patients undergoing laparoscopic cholecystectomy. Methods Sixty patients were randomly allocated to three groups: 15 minutes before operation , the patients in group A and B received intravenous of flurbiprofen 1mg·kg-1 ,group C received flurbiprofen 1mg·kg-110min before the end of operation; and postoperatively group A received normal saline 20 ml , group B and C received tramadol 1mg·kg-1. The effects of analgesia were assessed by visual analogue scale (VAS) at 30min, 1, 2, 4, 8, 12, 24h after operation, and side effects, the overall satisfaction on analgesic therapy were assessed. Results Incisional pain , visceral pain and shoulder-tip pain VAS in group B were lower than A and C during 24h after operation (P0.05). Side effects in 3 groups were similar(Ｐ0.05). The overall satisfaction on analgesic therapy were better in group B than group A and C (P0.05). Conclusion Flurbiprofen axetil can produce preemptive analgesia, associated with tramadol