目的 研究腹腔镜胆囊手术中联合应用氟比洛芬酯与地佐辛对患者的镇痛效果。方法 腹腔镜胆囊手术患者100例，随机均分为4组，每组25例，分别为氟比洛芬酯组、地佐辛组、氟比洛芬酯联合地佐辛组(联合用药组)和对照组。氟比洛芬酯组麻醉诱导用药前静脉滴注氟比洛芬酯1.5 mg/kg；地佐辛组静脉滴注地佐辛0.15 mg/kg；氟比洛芬酯联合地佐辛组静脉滴注氟比洛芬酯1.5 mg/kg+地佐辛0.15 mg/kg；对照组给予等容量生理盐水。记录各组术毕至拔除喉罩所用时间，术后2、4、6、12、24 h视觉模拟疼痛评分，并记录患者不良反应发生率。结果 （1）疼痛程度：氟比洛芬酯组与地佐辛组在2、4、6 h的VAS评分均低于对照组(P<0.05)，联合用药组在2、4、6、12 h的评分低于对照组，差异有统计学意义(P<0.05)。（2）不良反应发生率：与对照组比较，氟比洛芬酯组，地佐辛组，联合用药组患者术后24 h的恶心、呕吐及眩晕嗜睡不良反应发生率均较对照组增高(P<0.05)。联合用药组的眩晕嗜睡发生率高于氟比洛芬酯组(P<0.05)，呕吐发生率高于地佐辛组(P<0.05)。结论 在腹腔镜胆囊手术中，联合应用氟比洛芬酯与地佐辛镇痛效果好，但不良反应发生率增高。
Abstract
Objective To investigate the efficacy of flurbiprofenaxetil combined with dezocine during gallbladder removal surgery. Methods One hundred patients of ASAⅠ－Ⅱ undergoing gallbladder removal surgery were randomly assigned to four groups(n=25):flurbiprofenaxetil group, dezocine group, flurbiprofenaxetil combined with dezocine group and control group. Before anesthesia induction, flurbiprofenaxetil 1.5 mg/kg was injected intravenously in flurbiprofenaxetil group， dezocine 0.15 mg/kg in dezocine group, flurbiprofenaxetil 1.5 mg/kg combined with dezocine 0.15 mg/kg in flurbiprofenaxetil combined with dezocine group,while an equal volume of saline was given in control group. The extubation time and visual analgesia scale scores were recorded at 2,4,6,12 and 24 h after operation.The incidence of adverse reactions was recorded within 24 h. Results The VAS scores at 2,4,and 6 h were lower in flurbiprofenaxetil group and dezocine group than in control group (P<0.05), and were lower in flurbiprofenaxetil combined with dezocine group than in control group at 2,4,6 and 12 h (P<0.05). Compared with control group, the incidence of complications was increased in the other three groups (P<0.05). Compared with flurbiprofenaxetil combined with dezocine group, the incidence of dizziness and somnolence was decreased in flurbiprofenaxetil group(P<0.05), and that of nausea was decreased in dezocine group(P<0.05). Conclusions Flurbiprofenaxetil (1.5 mg/kg) combined with dezocine has (0.15 mg/kg）better analgesic effect, but the adverse reaction rate can increase in patients during gallbladder removal surgery.
关键词
氟比洛芬酯 /
地佐辛 /
腹腔镜 /
胆囊切除手术
Key words
flurbiprofen /
dezocine /
cholecystotomy /
gallbladder removal surgery
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