OBJECTIVE:To compare the blood coagulation and safety of flurbiprofen axetil,sufentany and lappaconitine combined with tramadol for postoperative intravenous analgesia in laparoscopic cholecystectomy. METHODS:180 patients who required intravenous analgesia after laparoscopic cholecystectomy were randomly divided into flurbiprofen axetil group(F),sufentany group (S)and lappaconitine group(L). All patients received intravenous electronic analgesia pump after intravenous anesthesia. Patients in group F were given 150 mg Flurbiprofen axetil injection;group S was given 100 ug Sufentany injection;and group L was given 24 mg Lappaconitine injection. Tramadol hydrochloride injection was used in each group for self-test of intravenous analgesia. VAS at the end of surgery and 4,8,16,24,36 and 48 h after surgery,PLT,MPV,PT,APTT,INR and ADR before surgery(T0),the end of surgery(T1),the first day(T2)and second day(T3)after surgery in 3 groups were observed. RESULTS:VAS scores after 4,8 and 16 h in group F and group S were significantly lower than the end of surgery and both group F and group S were lower than group L(P<0.05),however,there was no significant difference between group F and group S(P>0.05);when PLT were significantly lower than T0,PT and APTT at T1,T2 and T3 were significantly higher than T0,MPV in group S at T2 was significantly higher than T0,T1 and T3,MPV in group L at T2 and T3 was significantly higher than T0 and T1,INR in group F and group S at T1,T2 and T3 and group L at T1 was significantly higher than T0(P<0.05),and there was no significant difference in the MPV among 3 groups and group F at different time points(P>0.05). The incidence of adverse reactions in group F was significantly lower than group S and group L(P<0.05),however,there was no significant difference between group S and group L(P>0.05). CONCLUSIONS:Flurbiprofen axetil,sufentany and lappaconitine combined with tramadol can be used for postoperative intravenous analgesia in laparoscopic cholecystectomy,reduce the number of platelets,inhibite hypercoagulable state and prolong coagulation without bleeding tendency. But flurbiprofen axetil combined with tramadol has better safety.
Department of Neonatal Diagnosis and Treatment Center,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Pediatrics