摘要
目的对比氟比洛芬酯注射液和/或罗哌卡因注射液用于腹腔镜胆囊切除(LC)术后镇痛的临床疗效及安全性。方法将120例腹腔镜胆囊切除术患者随机分为A、B、C和D组,每组30例。A组于手术结束前不输注氟比洛芬酯和罗哌卡因,结束时也不在切口处进行局部麻醉;B组于手术结束前5 min给予静脉输注氟比洛芬酯50 mg,结束时不在切口处进行局部麻醉;C组于手术结束前不输注氟比洛芬酯和罗哌卡因,结束时用罗哌卡因10 mL在腹壁4个切口处进行均匀局部麻醉;D组于手术结束前静脉输注氟比洛芬酯50 mg,结束时用罗哌卡因10 mL在腹壁4个切口处进行均匀局部麻醉。比较4组患者的术后视觉模拟评分(VAS)、补救镇痛,以及药物不良反应的发生情况。结果A、B、C和D组的术后3 h VAS评分分别为(6.07±1.82),(3.20±1.40),(3.23±1.10)和(3.13±1.17),术后6 h VAS评分分别为(6.23±1.81),(4.63±1.69),(4.77±1.81)和(3.63±1.43),哌替啶使用率分别为50.00%(15例/30例),13.33%(4例/30例),16.67%(5例/30例)和16.67%(5例/30例),B、C和D组患者的上述指标与A组比较,差异均有统计学意义(均P<0.05),且D组的术后6 h VAS评分与B、C组比较,差异均有统计学意义(均P<0.05)。4组患者的药物不良反应主要有恶心呕吐,此外D组还有皮肤瘙痒的发生。A、B、C和D组的总药物不良反应发生率分别为10.00%,13.33%,10.00%和16.67%,差异均无统计学意义(均P>0.05)。结论氟比洛芬酯注射液和罗哌卡因注射液在LC术后3 h和6 h内对患者镇痛的效果确切,而且术后6 h时两药的联合镇痛效果更佳。
Objective To observe the effects of flurbiprofen axetil injection and/or ropivacaine injection on pain management and security in patients undergoing laparoscopic cholecystectomy(LC).Methods A total of 120 patients undergoing LC were randomly divided into 4 groups.Neither flurbiprofen axetil nor ropivacaine was given in group A.Group B was treated with flurbiprofen axetil 50 mg,intravenous infusion at 5 min before the end of the operation and no ropivacaine was applied.Group C only received local anesthesia using 10 mL ropivacaine along the four abdominal incisions at the end of the operation and the flurbiprofen axetil was not used.The two methods mentioned above were all added in group D to alleviate sufferings.After the surgery,visual analogue scale(VAS),the remedy analgesia,adverse drug reactions in four groups were compared respectively.Results At 3 h and 6 h after operation,the VAS scores in group A,B,C,D were(6.07±1.82)and(6.23±1.81),(3.20±1.40)and(4.63±1.69),(3.23±1.10)and(4.77±1.81),(3.13±1.17)and(3.63±1.43),respectively.The utilization rates of pethidine were 50.00%(15 cases/30 cases),13.33%(4 cases/30 cases),16.67%(5 cases/30 cases)and 16.67%(5 cases/30 cases).The above-mentioned datas of group B,C and D were significantly different from those of group A(all P<0.05).Furthermore,there were also significant differences between the VAS scores at 6 h after operation in group D and group B/C(all P<0.05).The adverse drug reactions of four groups were nausea and vomiting.In addition,skin itching also occurred in group D.The incidences of adverse drug reactions in each group were 10.00%,13.33%,10.00%and 16.67%,respectively.The differences between groups were not significant(all P>0.05).Conclusion Flurbiprofen axetil injection and ropivacaine injection are all effective in alleviating pain at 3 h and 6 h after LC,especially when the two were used in combination at 6 h after operation.
作者
张振亚
蒋艺
谢朝
姜楠
杨国山
ZHANG Zhen-ya;JIANG Yi;XIE Zhao;JIANG Nan;YANG Guo-shan(Department of General Surgery,First Hospital of Tsinghua University,Beijing 100016,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2019年第23期3017-3020,共4页
The Chinese Journal of Clinical Pharmacology
关键词
氟比洛芬酯注射液
罗哌卡因注射液
腹腔镜胆囊切除术
术后镇痛
安全性评价
flurbiprofen axetil injection
ropivacaine injection
laparoscopic cholecystectomy
postoperative analgesia
safety evaluation
