| Objective To explore the effect of ketorolac tromethamine and flurbiprofen ester on preemptive analgesia during laparoscopic cholecystectomy and its influence on postoperative recovery.Methods This trial was approved by the ethics committee of the hospital.With the informed consent of the patients and their families,90 patients who underwent elective laparoscopic cholecystectomy under general anesthesia in our hospital from December 2019 to December 2020 were selected,ASA grade I or Grade Ⅱ,patients aged 18 to 35 years old.Ninety patients were randomly divided into three groups,each with 30 cases,namely the normal saline group(C),the flurbiprofen ester group50 mg(F),and the ketorolac tromethaminegroup 30 mg(K).After entering the operating room,the 3 groups established upper limb venous channels,infused with compound sodium chloride injection,and continuously monitored blood pressure(BP),heart rate(HR),electrocardiogram(ECG),blood oxygen saturation(Sp O2),and respiratory rate(RR),15 min before induction of anesthesia,group C was given 5ml saline,group F was given 50 mg flurbiprofen ester,group K was given 30 mg ketorolac tromethamine,all three groups were given a small pot of slow intravenous drip,15 minutes later Routine anesthesia.Before T0 induction,1h after T1,6h after T2,12 h after T3,24 h after T4,VAS dynamic and static scores,BCS patient comfort score,blood glucose at various time points were collected;and at T0,T2,T4 The inflammatory indicators of IL-6 and TNF-α at three-time points;the incidence of adverse reactions such as nausea and vomiting,and the number of additional postoperative analgesics.Results(1)The comparison of general data of the three groups of patients was not statistically significant(P>0.05);(2)Compared with T0,the blood glucose levels of patients in all three groups at time points T1,T2,T3,and T4 increased significantly,and the comparison within the groups was statistically significant(P<0.05);compared with group C,blood glucose in group F at time points T1,T2 and T3 decreased significantly,and in group K at time points T2 and T3 decreased significantly;compared with group K,blood glucose in group F at time points T2 and T3 decreased significantly,with statistically significant(P<0.05);(3)Compared with T0,the static VAS scores of the three groups at T1,T2,T3,and T4 all increased significantly,and the intra-group comparison was statistically significant(P<0.05);compared with group C,T1,T2,T3 At the time point,the F group and the K group were significantly reduced,with statistical significance(P<0.05);compared with the K group,there was no statistical significance compared with the F group at any time point(P>0.05);(4)Compared with T0,the dynamic VAS scores of the three groups at T1,T2,T3,and T4 all increased significantly,and the intra-group comparison was statistically significant(P<0.05);compared with group C,at T1 and T3 time The scores of group F and K were significantly reduced(P<0.05);compared with group K,group F was significantly reduced at a T2 time point,which was statistically significant(P<0.05);(5)Compared with T0,the BCS scores of patients in the three groups at T2,T3,and T4 were significantly lower,and the intra-group comparison was statistically significant(P<0.05);compared with group C,the T2 and T3 time points were F Group K increased significantly(P<0.05),and group K increased significantly at time T2;compared with group K,group F increased significantly at time T2,which was statistically significant(P<0.05);(6)Compared with T0,the levels of IL-6 in the three groups at T2 and T4 were significantly higher(P<0.05);compared with group C,the levels of IL-6 at T2 and T4 were significantly lower in groups F and K;and Compared with group K,group F at T2 and T4 time points were significantly reduced,which was statistically significant(P<0.05);(7)Compared with T0,the levels of TNF-α in the three groups at T2 and T4 were significantly increased(P<0.05);compared with group C,the levels of TNF-α at T2 and T4 were significantly lower in groups F and K;and Compared with group K,group F at T2 and T4 time points were significantly reduced,which was statistically significant(P<0.05);(8)The difference in the rates of postoperative nausea and vomiting and other adverse reactions among the three groups was not statistically significant(P>0.05),and the rate of additional postoperative analgesia was significantly higher in Group C than in the other two groups(P<0.05).Conclusion1.Administration of non-steroidal anti-inflammatory drugs before induction of anesthesia can effectively alleviate postoperative pain and reduce the number of additional analgesics after surgery.2.Both flurbiprofen ester and ketorolac tromethamine can significantly reduce the inflammatory factors in the body,but flurbiprofen ester may reduce inflammatory cytokines to a lesser extent,and there is no difference between the two in postoperative nausea and vomiting. |
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