氟比洛芬酯超前镇痛联合Narcotrend监测在腹腔镜胆囊切除术中的应用

摘要

Objective To investigate the efficacy of flurbiprofen axetil preemptive analgesia combined with Narcotrend monitoring applied to laparoscopic cholecystectomy( LC) . Methods A total of 50 patients underwent LC were randomly divided into observation group and control group,with 25 cases in each group. The patients in the observation group were injected with flurbiprofen axetil intravenously at 20 minutes before operation, and the control group with an equivalent volume of normal saline. The target concentration of propofol was monitored by Narcotrend monitoring in the two groups. The operation duration, intraoperative blood loss, duration of pneumoperitoneum, dosage of sufentanil and propofol during operation were compared between the two groups. The Visual Analogue Scale( VAS) score and Ramsay Sedation Scale score after 30 minutes of recovery,and incidence of adverse reactions within 72 hours after operation were observed in the two groups. Results There was no significant difference between the two groups in the operation duration,intraoperative blood loss, duration of pneumoperitoneum or intraoperative propofol dosage(all P>0. 05);the dosage of intraoperative sufentanil in the observation group was less than that in the control group(P<0. 05). After 30 minutes of anesthesia recovery,the VAS score of the observation group was lower than that of the control group(P<0. 05),but no significant difference was observed in the Ramsay score between the two groups (P>0. 05). There was no significant difference in the total incidence rate of adverse reactions within 72 hours after operation between the two groups(P>0. 05). Conclusion With the Narcotrend monitoring,preemptive analgesia with flurbiprofen axetil before LC can reduce the intraoperative dosage of sufentanil and relieve the postoperative pain.%目的 探讨氟比洛芬酯超前镇痛联合Narcotrend监测在腹腔镜胆囊切除术(LC)中的应用效果.方法 将施行LC手术的患者50例,随机分为观察组和对照组,每组25例.观察组术前20 min静脉注射氟比洛芬酯,对照组注射等量生理盐水.两组均通过Narcotrend监测指导丙泊酚的靶控浓度.比较两组患者手术时间、术中出血量、手术气腹时间、术中舒芬太尼及丙泊酚用量,观察两组手术苏醒后30 min视觉疼痛模拟评分(VAS)、镇静Ramsay评分及术后72 h内不良反应发生情况.结果 两组患者手术时间、术中出血量、手术气腹时间及术中丙泊酚用量比较,差异均无统计学意义(均P>0.05);观察组患者术中舒芬太尼用量少于对照组(P<0.05).观察组麻醉苏醒后30 min VAS评分低于对照组(P<0.05),但两组Ramsay评分比较,差异无统计学意义(P>0.05).两组术后72 h不良反应总发生率比较,差异无统计学意义(P>0.05).结论 在Narcotrend系统监测下,LC术前应用氟比洛芬酯超前镇痛可减少术中舒芬太尼的用量,减轻术后疼痛.