关键词: 子宫切除术, 地佐辛, 氟比洛芬酯

Abstract: Objective  To explore the analgesic effect of combined dezocine and flurbiprofen axetil in patients undergoing total laparoscopic hysterectomy(TLH) and its influence on stress indicators and plasma cytokines. 
Methods  The clinical data of 60 patients undergoing TLH were retrospectively analyzed. According to the method of anesthesia, they were divided into the control group and the observation group, with 30 cases in each group. The control group was given sufentanil for analgesia, and the observation group was given dezocine combined with flurbiprofen axetil for analgesia. VAS scores and Ramsay scores immediately after surgery, at 12 h after surgery, and at 24 h after surgery were compared between two groups. The stress response ［malondialdehyde(MDA), cortisol(Cor), adrenaline(E), norepin ephrine(NE)］ and plasma cytokines ［tumor necrosis factor-α(TNF-α), interleukin-2(IL-2), interleukin-6(IL-6), interleukin-10(IL-10)］ levels of the two groups were compared before and immediately after establishing the vein passage, at 24 h after the surgery, and at 48 h after the surgery. 
Results  The VAS scores of the two groups increased initially and then decreased. The VAS scores of the observation group were lower than those of the control group, and the differences between groups and time points were statistically significant(P＜0.05). There was no statistical difference in the interaction between groups and time points(P＞0.05). The Ramsay scores of the two groups showed a gradual decrease. The Ramsay scores of the observation group were higher than those of the control group, and the differences in interaction between groups, time points, and time points between groups were statistically significant(P＜0.05). The levels of MDA, Cor, E, and NE in the two groups increased initially and then decreased. The levels of MDA, Cor, E, and NE in the observation group changed less than those in the control group. The difference in interaction between groups, time points, and time points between groups were statistically significant(P＜0.05). TNF-α, IL-2, IL-6, and IL-10 in the two groups showed a trend of initial increase and then decrease. The levels of TNF-α, IL-2, IL-6, and IL-10 in the observation group changed less than those in the control group, and there were statistically significant differences in the interaction between groups, time points, and time points between groups(P＜0.05). 
Conclusion  Dezocine combined with flurbiprofen axetil is effective for patients undergoing TLH, which can relieve excessive stress reaction and obtain satisfactory sedation and analgesia.

Key words: hysterectomy, dezocine, flurbiprofen axetil