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| 对乙酰氨基酚甘露醇与氟比洛芬酯用于胸腔镜肺癌根治术后镇痛效果的比较 |
| Comparison on postoperative analgesic effect of intravenous paracetamol and mannitol injection with flurbiprofen axetil on thoracoscopic radical resection of lung cancer |
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| DOI：10.12089/jca.2024.12.008 |
| 中文关键词: 对乙酰氨基酚甘露醇注射液 氟比洛芬酯 术后镇痛 胸腔镜肺癌根治术 患者自控静脉镇痛 |
| 英文关键词: Paracetamol mannitol Flurbiprofen axetil Postoperative analgesia Thoracoscopic radical resection of lung cancer Patient-controlled intravenous analgesia |
| 基金项目:中国红十字基金会医学赋能公益专项基金镇痛行动临床科研项目（CRCF-YXFN-202301038） |
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| 中文摘要: |
目的：比较对乙酰氨基酚甘露醇与氟比洛芬酯在胸腔镜肺癌根治术后的镇痛效果。
方法：选择择期行胸腔镜肺癌根治术的患者97例，男33例，女64例，年龄18～70岁，BMI 18.5～28.0 kg/m 2，ASA Ⅰ—Ⅲ级。采用随机数字表法将患者分为两组：对乙酰氨基酚甘露醇组（T组，n=48）和氟比洛芬酯组（F组，n=49）。手术切皮前，T组静脉滴注对乙酰氨基酚甘露醇注射液50 ml（50.mg），术后2 d每隔12 h静脉滴注相同剂量；F组于术前及术后相同时点静脉注射氟比洛芬酯50 mg。术后采用患者自控静脉镇痛（PCIA），静脉注射曲马多50 mg补救镇痛。记录术后1、6、12、24、48 h静息和活动（咳嗽）时VAS疼痛评分。记录术中舒芬太尼用量、输液量、尿量、拔管时间、PACU停留时间。记录术后镇痛泵首次按压时间、总按压和有效按压次数、羟考酮用量、术后补救镇痛情况、总住院时间和术后不良反应的发生情况。
结果：与F组比较，T组术后6 h活动时VAS疼痛评分明显降低（P<0.05），术中尿量明显升高（P<0.05），术后恶心呕吐的发生率明显降低（P<0.05）。两组术中舒芬太尼用量、输液量、拔管时间、PACU停留时间、术后镇痛泵首次按压时间、总按压和有效按压次数、羟考酮用量、术后补救镇痛率、总住院时间差异无统计学意义。
结论：对乙酰氨基酚甘露醇可为胸腔镜肺癌根治术患者提供与氟比洛芬酯相似的术后镇痛效果，且术后恶心呕吐的发生率更低。 |
| 英文摘要: |
Objective: To compare the postoperative analgesic effect of intravenous paracetamol and mannitol injection with that of flurbiprofen axetil on thoracoscopic radical resection of lung cancer.
Methods: Ninety-seven patients, aged 18-70 years, BMI 18.5-28.0 kg/m 2, ASA physical status Ⅰ-Ⅲ, undergoing thoracoscopic radical resection of lung cancer were selected in this study. The patients were divided into two groups: paracetamol and mannitol injection group (group T, n = 48) and flurbiprofen axetil group (group F, n = 49) according to the random number method. Before skin incision, paracetamol and mannitol injection 50 ml (50.mg) was intravenously infused in group T, and the same dose was intravenously infused every 12 hours within 2 days after operation. In group F, flurbiprofen axetil 50 mg was intravenously injected before and at the same time point after operation. Patient-controlled intravenous analgesia was performed after surgery and tramadol 50 mg were administered intravenously when patients required remedial analgesia. Visual analog scale (VAS) scores at rest and coughing were recorded at 1 hour, 6, 12, 24, and 48 hours postoperatively to evaluate postoperative pain. The first time to use analgesic pump, the total consumption of oxycodone in the analgesic pump, number of effective and total analgesic pump compressions at first 48 hours postoperatively, the perioperative consumption of sufentanil, time to extubation, hospital length of stay, urine volume, and the incidence of adverse events were also recorded.
Results: Compared with group F, the VAS score at coughing 6 hours after operation and the incidence of nausea and vomiting were significantly reduced (P < 0.05). The intraoperative urine volume in group T was significantly higher than that in group F (P < 0.05). There were no significant differences between the two groups in the consumption of sufentanil, infusion volume, extubation time, PACU stay time, the first pressing time, total pressure and effective pressure times, oxycodone consumption, and hospital stay.
Conclusion: Intravenous paracetamol and mannitol injection can produce an equivalent analgesic effect to flurbiprofen in thoracoscopic radical resection of lung cancer patients and decrease incidence of nausea and vomiting. |
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