氟比洛芬酯用于腹腔镜胆囊切除术后自控静脉镇痛

目的探讨氟比洛芬酯用于腹腔镜胆囊切除（Lc）术后自控静脉镇痛（PCIA）的镇痛效果和不良反应。方法48例Lc术患者，随机分为三组：芬太尼组（A组）、氟比洛芬酯组（B组）以及氟比洛芬酯复合芬太尼组（c组），术毕前15min各组均静注氟比洛芬酯50mg，术后PCIA泵用药为：A组、芬太尼1mg加0．9％氯化钠注射液稀释至100mL；B组、氟比洛芬酯100mg加0．9％氯化钠注射液稀释至100mL；C组、氟比洛芬酯50mg＋芬太尼0．5mg加0．9％氯化钠注射液稀释至100mL。记录各组疼痛视觉模拟评分（VAS）、生命体征、满意度及不良反应情况。结果各组患者术后各时点的VAS评分及生命体征同手术前比较差异均无统计学意义；各组对术后镇痛的满意度差异无统计学意义，但A组患者按压镇痛泵的次数（6．9±1．3）次明显多于B组的（2．7±1．1）次和C组的（2．3±1．2）次（q=13．84、14．98，均P〈0．01）；恶心与头晕的发生率C组（0、12．5％）均显著低于A组（37．5％、68．8％）（u=2．717、3．217，均P〈0．叭），B组头晕发生率（18．8％）也显著低于A组（68．8％）（M=2．857，P〈0．01）。结论氟比洛芬酯可安全用于Lc患者PCIA，镇痛效果确切，不良反应较少。

Application of flurbiprofen axetil in postoperative patient-controlled intravenous analgesia of laparoscopic cholecystectomy patients

Objective To investigate the analgesic efficacy and adverse reactions of flurbiprofen axetil in postoperative patient-controlled intravenous analgesia （PCIA） of laparoscopic cholecystectomy （ LC ）. Methods 48 cases of LC were randomly divided into three groups：fentanyl group（ group A）, flurbiprofen axetil group（ group B ） and flurbiprofen axetil compound fentanyl group（ group C ）. Each group was intravenously injected flurbiprofen axetil 50mg 15 minutes before the surgery. The drugs use for postoperative PCIA pump：group A,fentanyl lmg plus saline di- luted to lOOmL;group B,flurbiprofen axetil 100mg plus saline diluted to 100mL;group C,flurbiprofen axetil 50rag ＋ fentanyl O. 5 mg plus saline diluted to 100mL. The pain visual analog scale （ VAS）, vital signs, satisfaction and adverse reactions were recorded. Results Each group＇s postoperative VAS scores at each time point and vital signs had no statistically significant differences compared with before surgery. Tbe satisfaction of postoperative pain among three groups had no significant difference, but the numbers of pressing analgesia pump in group A （ 6.9 ＋ 1.3 ） time was sig- nificantly more than that in group B （ 2.7 _＋ 1.1 ） time and group C （ 2.3 ＋ 1.2 ） time （ q = 13.84,14.98, all P 〈 0. O1 ）. The incidence rates of nausea and dizziness in group C （0,12.5%） were significantly lower than in group A （37.5 %, 68.8 % ） （ u = 2.717,3.217, all P 〈 0.01 ）, and the incidence rate of dizziness in group B （ 18.8% ） was significantly lower than group A （68.8%） （ u = 2. 857, P 〈 O. 01 ）. Conclusion Flurbiprofen axetil could be used safely in PCIA for the LC patients,the analgesic effect was exact and adverse reactions were fewer.