摘要
目的评价氟比洛芬复合芬太尼应用于中等手术患者围术期镇痛的效果及安全性。方法192例患者随机分为4组,常规采用静吸复合全身麻醉,根据手术时间对术中芬太尼总量进行控制,氟比洛芬按照以下方案给予。A组:术前不予氟比洛芬,术后予芬太尼1 mg+0.9%氯化钠溶液至100 mL进行镇痛。B组:术前予氟比洛芬50 mg,术后予芬太尼1 mg+0.9%氯化钠溶液至100 mL进行镇痛。C组:术前予氟比洛芬50 mg,术后予氟比洛芬100 mg+芬太尼0.5 mg+0.9%氯化钠溶液至100 mL进行镇痛。D组:术前予氟比洛芬50 mg,术后予氟比洛芬150 mg+芬太尼0.5 mg+0.9%氯化钠溶液至100 mL进行镇痛。患者自控镇痛(PCA)方案:背景剂量为2 mL/h,冲击剂量为2 mL,锁定时间为10 min。术后随访24 h,记录生命体征、镇痛情况及不良反应。结果共191例患者完成本研究,4组间一般情况的差异均无统计学意义(P值均>0.05),术后24 h内生命体征基本平稳。A组苏醒时的疼痛视觉模拟评分(VAS评分)显著高于其他3组(P值均<0.05),术后4、8和24 h的VAS评分显著高于C、D组(P值均<0.05);B组患者术后24 h的VAS评分显著高于C、D组(P值均<0.05)。C、D组的PCA按压次数和芬太尼用量均显著少于A、B组(P值均<0.05)。D组呕吐发生率显著高于其他3组(P值均<0.05)。结论氟比洛芬复合芬太尼应用于中等手术患者围术期镇痛具有确切的疗效,不良反应发生率较低,可安全用于临床。
Objective To assess the efficiency and safety of fturbiprofen combined with fentanyl for perioperative analgesia. Methods One hundred and ninet-two patients were randomly assigned to four groups. Group A： Postoperatively, fentanyl 1 mg＋0.90% NaC1 to 100 mL. Group B： Flurbiprofen 50 mg was injected preoperatively. Postoperatively, fentanyl 1 mg＋0.9% NaCl to 100 mL. Group C： Flurbiprofen 50 mg was injected preoperatively. Postoperatively, flurbiprofen 100 mg＋fentanyl 0.5 mg＋0.9% NaCl to 100 mL. Group D： Flurbiprofen 50 mg was injected, preoperatively. Postoperatively, flurhiprofen 150 mg＋fentanyl 0.5 mg＋ 0.9% NaCl to 100 mL. Patient controlled analgesia （PCA）： background dose 2 mL/h, pulse dose 2 mL, lockout time 10 min. The patients were followed up for 24 h after operation and vital signs, analgesia effect, and adverse effect were recorded. Results No significant differences were found in the age, body mass index and surgery duration among the 4 groups. The vital signs were stable within 24 b after operation. Patients in group A had higher visual analog scale （VAS） than those in the other 3 groups at regaining consciousness （all P〈 0.05）. At 4, 8, and 24 h after the operation, the VAS in group A was significantly higher than those in group C and D （all P〈0.05） ; at 24 h after the surgery, the VAS in group B was higher than those in group C and D （both P〈0.05）. The times of PCA and the amount of fentanyl in group C, D were significantly lower than those of group A, B （all P〈0.05）. The incidence of nausea in group D was higher than those in the other three groups （all P〈 0.05）. Conclusion Peri-operative analgesia with flurbiprofen and fentanyl has a definite analgesic effect and less adverse effects, and can be safely used in the clinic.
出处
《上海医学》
CAS
CSCD
北大核心
2008年第9期638-641,共4页
Shanghai Medical Journal
关键词
氟比洛芬
芬太尼
围术期镇痛
Flurbiprofen
Fentanyl
Peri-operative analgesia
