Objective: To investigate the effects of postoperative analgesia after laparoscopic cholecystectomy using intravenous flurbiprofen combined with different concentrations of ropivacaine incision infiltration.
Methods: Eighty patients who underwent traditional laparoscopic cholecystectomy received standard general anesthesia. At the end of surgery, patients were randomly divided into four groups: group Con (control group: no analgesics was administered, n=20); group F (flurbiprofen group: 100 mg of flurbiprofen was given intravenously with no incision infiltration, n=20); group FR(0.25) (100 mg of flurbiprofen was given intravenously, combined with 0.25% ropivacaine incision infiltration, 2 mL per incision, 6 mL in total, n=20) and group FR(0.5) (100 mg of flurbiprofen was given intravenously, combined with 0.5% ropivacaine incision infiltration, 2 mL per incision, 6 mL in total, n=20). The intensity of postoperative pain was evaluated using numeric rating scale (NRS) in a double-blinded manner. Intramuscularly 50 mg of meperidin was administered as rescue medication when NRS was above 4. The NRS and the associated side effects were observed and recorded at the end of 0, 2, 6, 12, 24, and 48 hours postoperatively (T(0 h)h,T(2 h),T(6 h),T(12 h),T(24 h),and T(48 h)).
Results: There was no obvious difference among the four groups in respect of gender, age, body weight, baseline blood pressure, heart rate(HR), and total doses of sufentanil and remifentanil during operation and surgical time(P>0.05).There were significant differences among group FR(0.25)(2.34 ± 0.89,3.01 ± 1.27,2.79 ± 0.94), group FR(0.5)(2.42 ± 0.79, 2.69 ± 0.96, 2.03 ± 0.87)and group Con(3.42 ± 1.23, 5.98 ± 1.46, 4.53 ± 0.92)in NRS at T(2 h), T(6 h), and T(12 h)(P<0.05).Systolic blood pressures (SBP) of patients in group FR(0.25) [(114.19 ± .74) mmHg,(108.31 ± 7.62) mmHg) and group FR(0.5) [(115.26 ± 8.95) mmHg,(111.25 ± 9.12) mmHg] were significantly lower than those of patients in group Con [(137.11 ± 8.71) mmHg,(125.16 ± 8.92) mmHg] at T(2 h) and T(6 h)(P<0.05). Compared with group Con [(81.24 ± 6.64) beats/min], heart rate(HR) was also lower in patients of group FR(0.25) [(69.14 ± 5.92) beats/min] and group FR(0.5) [(70.16 ± 5.25) beats/min] at T(6 h)(P<0.05). There was no obvious adverse effect in all the four groups.
Conclusion: Intravenous flurbiprofen combined with ropivacaine infiltration could significantly reduce postoperative pain after laparoscopic cholecystectomy, providing more stable hemodynamics. Compared with 0.25% ropivacaine, 0.5% ropivacaine infiltration combined with intravenous flurbiprofen has better and longer analgesic effects.