目的:观察地佐辛联合氟比洛芬酯多模式复合镇痛对于预防超短效阿片类药物瑞芬太尼所引起的痛觉超敏的效果。方法筛选我院择期腹腔镜保胆取石术患者45例,ASA Ⅰ~Ⅱ级,年龄20~58岁,无明显重要脏器功能障碍。随机分成三组,D代表地佐辛组,F代表氟比洛芬酯组,D+F代表联合用药组,在术毕时给予相应剂量药物,观察3组患者在拔管10min、1h、2h、4h疼痛评分,同时记录三组患者苏醒期镇静评分、疼痛、恶心呕吐及拔管时间等指标。结果三组患者一般资料、拔管时间、术中丙泊酚及瑞芬太尼平均靶浓度之间比较差异均无统计学意义(P>0.05)。术后D+F组患者在4h内不同时段疼痛评分及躁动发生率明显优于D组及F组(P<0.05);D组在术后2h内疼痛评分优于F组(P<0.05),但在4h两组评分无明显差别(P>0.05)。D及D+F组恶心呕吐发生率较高,与F组相比有统计学差异(P<0.05)。结论地佐辛联合氟比洛芬酯可以有效的预防瑞芬太尼所引起的痛觉过敏反应。
Objective To study the effects of dezocine combined with flurbiprofen axetil multimodal analgesia preventing hyperalge-sia caused by using ultra short acting opioid.Methors:Petions of preserving cholelithotomy was administered.Fourty-five patients (Aged be-tween 35 and 45;ASA Ⅰ~Ⅱ)that didn t have obvious important viscera dysfunction,were randomly divided into three groups(D is defined dezocine group;F is defined flurbiprofen group,D+F is defined the combination group),and were given intravenous injection respectively fif-teen minutes before the operation.Patients in group D received 0.06mg/kg dezocine,group F 1mg/kg flurbiprofen axetil,and patiens in group D+F recieved 0.06 mg/kg dezocine and flurbiprofen axetil 1 mg/kg.Then dynamic observation of three groups was conducted in terms of gen-eral anesthesia to stir,pain,nausea or vomiting,and the time from completing surgery to pulling out the tube.Results The pain score of group D+F patients in different time of postoperative 4h significantly lower than in group D and group F(P<0.05);Pain score in 2hour after oper-ation of group D was lower than that in group F(P<0.05),but after 4 hours of scores between the two groups had no statistically significant (P>0.05);The incidence of nausea or vomiting in group D and D +F were more than in group F,which had statistically significant (P<0.05).Conclusion Using dezocine combined with flurbiprofen axetil before operation can effectively prevent the hyperalgesia caused by using remifentanil.