摘要
目的探讨氟比洛芬酯超前镇痛联合喷他佐辛术后镇痛在腹腔镜肾癌根治术中的应用效果。方法选取2014年1月～2017年12月在我院行腹腔镜肾癌根治术的40例患者作为研究对象,采用随机数字表法分为观察组和对照组,每组各20例。手术开始和结束前30 min,观察组给予氟比洛芬酯50 mg,对照组给予等容量生理盐水;手术结束前10 min接静脉镇痛泵,观察组给予舒芬太尼150μg+喷他佐辛60 mg+托烷司琼5 mg,对照组采用舒芬太尼200μg+托烷司琼5 mg。观察两组麻醉前(T0)、手术开始时(T1)、手术结束时(T2)、拔管时(T3)的平均动脉压(MAP)和心率(HR),检测两组麻醉前及术后2、12、24 h的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,记录两组术后2、12、24 h的VAS评分和BCS评分,比较两组术后的PCIA按压次数及不良反应发生情况。结果观察组T1、T2、T3时的MAP和HR均低于对照组(P<0.05);观察组术后12、24 h的IL-6、TNF-α水平均低于对照组(P<0.05);观察组术后2、12、24 h的VAS评分低于对照组,BCS评分高于对照组(P<0.05);观察组术后的PCIA按压次数少于对照组,恶心发生率低于对照组,差异有统计学意义(P<0.05)。结论氟比洛芬酯超前镇痛联合喷他佐辛术后镇痛应用于腹腔镜肾癌根治术中的镇痛效果确切,可有效降低围术期应激反应,且不良反应少。
Objective To investigate the application effect of preemptive analgesia with Flurbiprofen Axetil and postoperative analgesia with Pentazocine for laparoscopic radical nephrectomy.Methods A total of 40 patients with laparoscopic radical nephrectomy from January 2014 to December 2017 were selected and randomly divided into the observation group and the control group,20 patients in each group.Patients in the observation group were given Flurbiprofen Axetil with 50 mg half an hour before the start and the end of the surgery,while patients in the control group were given the same volume of physiological saline.All patients were treated with intravenous controlled analgesia pump 10 minutes before the end of the operation.Patients in the observation group were treated with Sufentanil with 150μg+Pentazocine with 60 mg+Tropisetron with 5 mg,while patients in the control group were treated with Sufentanil with 200μg+Tropisetron with 5 mg.The mean arterial pressure(MAP)and heart rate(HR)were observed before anesthetization(T0)and at the time of operation starting(T1),operation ending(T2)and extubation(T3)in the two groups.The levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were detected before anesthetization and at the time of 2,12,24 h after operation in the two groups.The VAS scores and BCS scores were recorded at the time of 2,12,24 h after operation in the two groups.The press times of PCIA and the incidence rate of adverse reactions were observed in the two groups.Results At T1,T2 and T3,the values of MAP and HR in the observation group were significantly lower than those in the control group(P<0.05).At the 12 h and 24 h after operation,the level of IL-6 and TNF-αin the observation group were significantly lower than those in the control group(P<0.05).The VAS scores in the observation group were significantly higher than those in the control group(P<0.05)at the same time point,while the BCS scores in the observation group were significantly lower than those in the control group(P<0.05)at the same time point.The press times of PCIA in the observation group were significantly lower than those in the control group(P<0.05),and the incidence of postoperative nausea in the observation group was significantly lower than those in the control group,with significant difference(P<0.05).Conclusion The analgesic effect of preemptive analgesia with Flurbiprofen Axetil and postoperative analgesia with Pentazocine for laparoscopic radical nephrectomy is definite,which can effectively reduce the stress response and adverse reactions.
作者
张古月
李寒阳
陆良愿
ZHANG Gu-yue;LI Han-yang;aLU Liang-yuan(Department of Anesthesiology,Aerospace Center Hospital,Beijing 100049,China)
出处
《中国当代医药》
2019年第3期74-77,共4页
China Modern Medicine
关键词
氟比洛芬酯
超前镇痛
喷他佐辛
术后镇痛
腹腔镜肾癌根治术
Flurbiprofen Axetil
Preemptive analgesia
Pentazocine
Postoperative analgesia
Laparoscopic radical nephrectomy
