| Objective:This paper aims to investigate the effect of preemptive analgesia with Flurbiprofen axetil combined with Lidocaine on the quality of general anesthesia recovery and postoperative pain in patients undergoing total hysterectomy with double appendages.Methods:With the consent of the ethics committee of our hospital,80 cases of patients undergoing total hysterectomy in the Affiliated Hospital of Chengde Medical College were selected from August 2018 to August 2019.The requirements aer 25-60 years of age to sign the relevant informed consent;ASA grades I to II;BMI greater than 18.5 kg / m2 and less than 25 kg / m2;patients who are not allergic to the drugs used.Grouped according to the random number standard method,it is divided into 4 groups: Group L: a single intravenous pump of lidocaine 1mg / kg 10 minutes before the induction of anesthesia(end of 1min)and continuous infusion of lidocaine 1mg / kg / h during the operation Continue until the end of surgery;Group F: Single intravenous pump of flurbiprofen 1 mg / kg 10 minutes before induction of anesthesia(1 minute complete);L + F Group: Single intravenous pump of lidocaine 1 mg / kg 10 minutes before induction of anesthesia And flurbiprofen ester 1mg / kg(dual-channel pumping,1min pumping completed)and continuous infusion of lidocaine 1mg / kg / h during the operation until the end of the operation;group C: do not do any of the above interventions.Record patient height,weight,and age.At admission(T0),before intubation(T1),at intubation(T2),at 1min(T3),at 30min(T4),at extubation(T5),at 1min(T6)after extubation,extubation Blood pressure and heart rate at 5 minutes(T7)after the tube.Record the anesthesia time,wake-up time(from the end of the operation to obeying the instructions to open the tongue)and extubation time(from the end of the operation to extubation).The RS agitation score and cough score at extubation(T5)were recorded.VAS scores were recorded 1 minute(T6),5 minutes(T7),and PACU(T8)after extubation.Record the additional analgesics when leaving PACU(T8).Nausea and vomiting,arrhythmia,and sore throat were recorded when leaving PACU(T8).P <0.05 was considered statistically significant.Results:1.There were no significant differences in the number of patients,BMI,age,operation time,wake-up time,extubation time,and propofol consumption in the four groups(P> 0.05).In terms of the amount of remifentanil,the LF group was lower than that of the L,F and C groups(P <0.05).2.Comparison of scooping cough score: group C was higher than the other three groups(P <0.05);group F was higher than LF and L groups(P <0.05);there was no significant difference between the LF group and the L group(P> 0.05).Comparison of RS scores: group C was higher than the other three groups(P <0.05);group F was higher than LF and L groups(P <0.05);there was no significant difference between LF group and L group(P > 0.05).3.Compared with time T0,the systolic blood pressure,diastolic blood pressure,and heart rate at the T1,T3,and T4 points of the four groups were all reduced,P <0.05;in the LF group,except for the time points of T1,T3,and T4,the systolic blood pressure and diastole at other time points Pressure and heart rate were basically stable,and there was no significant difference between the groups(P> 0.05).Compared with T0,the systolic blood pressure,diastolic blood pressure,and heart rate increased at time T2,T5,and T6 in group F(P <0.05).The systolic blood pressure,diastolic blood pressure,and heart rate at T2,T5,T6,and T7 in the L group all increased(P <0.05).Pairwise comparison: The LF group’s systolic blood pressure,diastolic blood pressure,and heart rate at T2,T5,T6,and T7 were lower than those of C,L,and F groups,Pa <0.05;group C had high systolic blood pressure at T2.In group L and LF,P <0.05;in group C,systolic blood pressure,diastolic blood pressure,and heart rate at T5,T6,and T7 were higher than those in the other three groups P <0.05;in group F and L,systolic blood pressure at T5 and T6 Greater than the LF group,P <0.05;the systolic blood pressure in the F and LF groups was higher than that in the C and L groups at T7,P <0.05;the diastolic blood pressure and heart rate were lower in the F and L groups at T2,T5,and T6 In group C,P <0.05;the diastolic blood pressure at T7 was higher in groups C and F than in group L,P <0.05;the snack rate in group L and LF was lower than that in group C at T7,P <0.05;The difference was not statistically significant,P> 0.05.4.VAS score: Group C was higher than the other three groups at T6,T7,and T8,P <0.05;group LF was lower than the other three groups at T6,T7,and T8,P <0.05;L Groups at T6,T7,and T8 were higher than those in Group F and LF at P <0.01;Group F was higher at T6 than at LF,P <0.05;there was no significant difference at the remaining points,P> 0.05.Sufentanil supplementation: Group C and L are more than group F and LF,P <0.05;compared with group LF,group C and group L have no statistically significant difference(P> 0.05);5.In terms of sore throat: the incidence of group C was higher than the other three groups(P <0.05);the incidence of group L and LF was lower than that of group F(P = 0.048 <0.05);there was no significant difference between the LF group and the L group(P> 0.05);Incidence of arrhythmia,nausea and vomiting: the incidence of the three groups was not statistically significant(P> 0.05);Conclusion:Both flurbiprofen and lidocaine can reduce the stress response during extubation and reduce the short-term postoperative VAS score.Combined application in advanced analgesia can increase wake quality,reduce the stress response such as coughing during extubation,and reduce short-term postoperative Pain,the effect is better than a single medication,does not inhibit breathing,does not affect postoperative wake-up time and extubation time,has important clinical application value,is safe to use,and is worthy of widespread promotion and application in clinical anesthesia... |
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