氟比洛芬酯联合后路腰方肌阻滞对腹腔镜结肠癌根治术患者镇痛效果、应激状态和疼痛因子的影响
Effects of Flurbiprofen Axetil Combined with Posterior Quadratus Lumborum Block on Analgesic Effect,Stress State and Pain Factors in Patients Undergoing Laparoscopic Radical Resection of Colon Cancer
李炎 1林聪 1俞敏 1于力 1吴霞1
作者信息
- 1. 南京医科大学第一附属医院(江苏省人民医院)麻醉与围术期医学科 江苏南京 210029
- 折叠
摘要
目的:探讨腹腔镜结肠癌(COAD)根治术患者麻醉期间使用氟比洛芬酯与后路腰方肌阻滞(QLB)复合麻醉,患者的镇痛效果和应激状态和疼痛因子变化情况.方法:采用随机数字表法将138例行COAD根治术的患者分为对照组(QLB治疗,n=69)和观察组(对照组的基础上结合氟比洛芬酯治疗,n=69).对比两组术后恢复指标、应激指标、疼痛因子,同时记录两组不良反应发生情况.结果:观察组术后第一次下床活动时间、首次排气时间、首次排便时间短于对照组(P＜0.05).观察组术后1dβ-内啡肽(β-EP)高于对照组,前列腺素E2(PGE2)、P物质(SP)、皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)低于对照组(P＜0.05).两组不良反应的发生率对比未见差异(P＞0.05).结论:氟比洛芬酯联合QLB用于COAD根治术患者,可降低疼痛因子水平进而减轻患者术后疼痛,有利于患者术后早期恢复.
Abstract
Objective:To investigate the analgesic effect,stress state and pain factors changes of patients undergoing laparoscopic radical resection of colon cancer(COAD)during anesthesia using flurbiprofen axetil combined with posterior quadratus lumborum block(QLB).Methods:138 patients undergoing COAD radical operation were divided into control group(QLB treatment,n=69)and observa-tion group(flurbiprofen axetil combined with QLB treatment,n=69)according to the random number table method.The postoperative re-covery indexes,stress indexes and pain factors were compared between the two groups,and the adverse reactions btween two groups were recorded.Results:The first time of getting out of bed,the first exhaust time and the first defecation time in observation group were shorter than those in control group(P＜0.05).The β-endorphin(β-EP)in observation group was higher than that in control group at 1 d after operation,and prostaglandin E2(PGE2),substance P(SP),cortisol(Cor),epinephrine(E)and norepinephrine(NE)were lower than those in control group(P＜0.05).There was no difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclu-sion:Flurbiprofen axetil combined with QLB for patients undergoing COAD radical resection,can reduce the level of pain factors and re-duce postoperative pain,which is conducive to early postoperative recovery.
关键词
腹腔镜结肠癌根治术/氟比洛芬酯/后路腰方肌阻滞/应激状态/镇痛效果/疼痛因子Key words
Laparoscopic radical resection of colon cancer/Flurbiprofen axetil/Posterior quadratus lumborum block/Stress state/Analgesic effect/Pain factors引用本文复制引用
出版年
2024
NETL
NSTL
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