摘要
目的:研究氟比洛芬酯对颅脑手术患者超前镇痛效果及对围术期血清炎性细胞因子水平的影响。方法:选择神经外科手术患者40例,ASAⅠ～Ⅱ级,随机分为C组和F组,每组20例。采用双盲法分别于气管插管后(切皮前15min)静脉注射氟比洛芬酯10mL(F组)或安慰剂(C组)10mL。记录术后2、24、48h的镇痛评分(VAS值)。在麻醉开始前(T1)、手术2h(T2)、术毕(T3)及术后24h(T4)测血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和IL-10含量。记录麻醉时间、术中出血量、尿量和手术输液量及瑞芬太尼和丙泊酚用量。结果:(1)术后2h和24h的VAS评分F组均较C组明显减低(P<0.05)。(2)F组瑞芬太尼和丙泊酚用量较C组明显降低(P<0.05)。(3)与T1比较,2组T2、T3时点血清TNF-α含量均明显升高(P<0.05),且在T2时点达高峰;与C组比较,F组T2～T4时点血清TNF-α含量明显降低(P<0.05)。与T1比较,2组T2～T4时点血清IL-6、IL-10含量均明显升高(P<0.05),且在T3时点达高峰;与C组比较,F组T2～T4时点血清IL-6含量降低、IL-10含量升高(P<0.05)。结论:术前预给氟比洛芬酯注射液具有确切的超前镇痛作用,并能降低颅脑手术围手术期应激炎性反应。
Objective：To investigate the preemptive analgesic effect of flurbiprofen on inflammatory cytokine in patients undergoing cerebral operation.Methods：Forty ASA I-Ⅱpatients undergoing cerebral surgery were randomly divided into control group（group C,n=20） and flurbiprofen group（group F,n=20）.Flurbiprofen of 10 mL was given intravenously 15 min before skin incision.The values of VAS scores were recorded at 2 h,24 h and 48 h after operation.Blood samples were taken for determination of serum levels of TNF-α,IL-6 and IL-10 immediately before induction of anesthesia（T1,baseline）,at 2 h of operation （T2）,immediately after the end of operation （T3） and 24 h after operation （T4）.The parameters of anaesthesia time,hemorrhage volume,urine volume,transfusion volume and the dosage of remifentanil and propofol were recorded during the period of anaesthesia.Results：The VAS score was lower in group F than that in group C at 2 h and 24 h after operation （P〈0.05）,but there was no difference at 48 h after operation between the two groups （P〉0.05）.The dosages of remifentanil and propofol were lower during anaesthesia in group F than that in group C （P〈0.05）.Compared with T1,TNF-α was significantly increased at T2 and T3 in both groups,and the peak value at T2 （P〈0.05）.TNF-α was decreased at T2-T4 in group F than that in group C （P〈0.05）.Compared with T1,the levels of IL-6 and IL-10 were significantly increased at T2-T4 in both groups,and the peak value at T3（P〈0.05）.The value of IL-6 was decreased and the value of IL-10 was increased at T2-T4 in group F than those in group C （P〈0.05）.Conclusion：Flurbiprofen was suitable as a preemptive analgesia and could suppress stress reaction of inflammatory in neurosurgery.
出处
《天津医药》
CAS
北大核心
2010年第2期90-93,共4页
Tianjin Medical Journal
