氟比洛芬酯、地佐辛单独或复合用药减轻瑞芬太尼诱发病人术后痛觉过敏的疗效

张云云; 张地宝; 盛胜; 缪欢兰; 骆宏

doi:10.13898/j.cnki.issn.1000-2200.2017.04.013

氟比洛芬酯、地佐辛单独或复合用药减轻瑞芬太尼诱发病人术后痛觉过敏的疗效

Study on flurbiprofen,dezocine and flurbiprofen combined with dezocine in relieving postoperative hyperalgesia induced by remifentanil

摘要

摘要: 目的：探讨氟比洛芬酯、地佐辛单独或复合用药减轻瑞芬太尼诱发病人术后痛觉过敏的效果。方法：择期行腹腔镜手术病人120例，均给予常规瑞芬太尼复合麻醉。病人ASA分级Ⅰ~Ⅱ级，采用随机数字法将病人分为3组（n=40）：F组麻醉前预给氟比洛芬酯2 mg/kg，术毕结束前30 min给予等容量的0.9%氯化钠注射液；D组麻醉前给予等容量0.9%氯化钠注射液，术毕结束前30 min给予地佐辛组0.2 mg/kg；F+D组麻醉前预给氟比洛芬酯1 mg/kg，术毕结束前30 min给予地佐辛0.1 mg/kg。观察并记录病人缝皮结束时（T₁）、拔喉罩时（T₂）、拔喉罩后30 min（T₃）的平均动脉压、心率；记录恶心、呕吐、眩晕、嗜睡的发生率；记录病人苏醒期疼痛视觉模拟评分。结果：3组病人术后T₁、T₂、T₃时间的平均动脉压和心率变化差异均无统计学意义（P>0.05）。3组手术病人术后恶心、呕吐、眩晕及嗜睡发生率差异均有统计学意义（P<0.01），与D组和F+D组比较，F组术后恶心、呕吐的发生率升高显著（P<0.01）；与F组和F+D组比较，D组眩晕、嗜睡的发生率升高显著（P<0.01）。3组手术病人术后苏醒期疼痛视觉模拟评分差异有统计学意义（P<0.01），F+D组分别与F组和D组比较，差异均有统计学意义（P<0.01），F组与D组比较差异无统计学意义（P>0.05）。结论：氟比洛芬酯、地佐辛复合用药可以减轻瑞芬太尼诱发病人术后痛觉过敏的效果优于两者单独使用。

Abstract: Objective:To investigate the effects of flurbiprofen,dezocine,flurbiprofen combined with dezocine on relieving postoperative hyperalgesia induced by remifentanil.Methods:One hundred and twenty patients scheduled by laparoscopic surgery were anesthesized using conventional remifentanil.The patients with ASA grade Ⅰto Ⅱ were divided into group F,group D and group F combined with D using random number method(40 cases each group).The group F was treated with 2 mg/kg of flurbiprofen axetil before anesthesia,and same volume of 0.9% NaCl injection before 30 min of the end of operation.The group D was treated with the same volume of 0.9% NaCl injection before anesthesia,and 0.2 mg/kg of dezocine before 30 min of the end of operation.The group D combined with F was treated with 1 mg/kg of flurbiprofen axetil before anesthesia,and 0.1 mg/kg of dezocine before 30 min of the end of operation.The mean arterial pressure and heart rate in three groups were observed and recorded at the end of sewing skin(T₁),extubating laryngeal mask(T₂) and 30 min after extubating laryngeal mask(T₃).The incidence rates of nausea,vomiting,dizziness and somnolence,and VAS score in three groups were recorded.Results:The differences of the levels of the mean arterial pressure and heart rate at T₁,T₂ and T₃ between three groups were not statistically significant(P>0.05).The differences of the incidence rates of nausea,vomiting,dizziness and somnolence after operation between three groups were statistically significant(P<0.01).Compared with group D and group F combined with D,the incidence rates of postoperative nausea and vomiting in group F significantly increased(P<0.01).Compared with group F and group F combined with D,the incidence rates of postoperative dizziness and somnolence in D group significantly increased(P<0.01).During the postoperative recovery period,the differences of the VAS scores between three groups were statistical significance(P<0.01),the differences of the VAS scores between group F combined with D and group F,and between group F combined with D and group D were statistically significant(P<0.01),and the difference of the VAS score between group F and group D was not statistically significant(P>0.05).Conclusions:The effect of flurbiprofen combined with dezocine on relieving postoperative hyperalgesia induced by remifentanil is better than that of flurbiprofen or dezocine.

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