氟比洛芬酯超前镇痛在小儿腹腔镜手术中的运用

目的：探讨氟比洛超前镇痛用于小儿腹腔镜下腹部手术的可行性、安全性和实用性。方法：选择2-5岁A5AⅠ-Ⅱ级腹腔镜下行疝囊腹壁内环口高位结扎术患儿60例，以静注氯胺酮、咪唑安定为基础麻醉，随机分为两组。对照组（C）组30例，手术前5分钟静注氯胺酮、芬太尼。氟比洛芬酯（F）组30例、手术前5分钟静注氨胺酮、芬太尼及氟比洛芬酯。两组患儿术中根据生命征变化情况静注小剂量芬太尼。患儿入睡后常规面罩给氧，术中连续监测HR、R、SBP、DBP、SpO2、观察两组患儿术毕清醒时间，清醒后躁动的发生率，及术中静注芬太尼的例数。结果：两组患儿术中安静，肌松良好，能满足手术要求，C组气腹后HR、SBP、DBP高于气腹前（P〈0.05），但沿在正常范围，组间比较F组术中生命征平稳（P〈0.05），术中C组R减慢（P〉0.05）。两组SpO2为98%-100%，无差异，F组术中须静注芬太尼的例数少于C组，苏醒时间C组明显长于F组（P〈0.05）,且醒后躁动的发生率比F组高（P〉0.05）。结论：氟比洛芬酯用于手术时间较短的腹腔镜小儿手术效果确切，术中生命征平稳，术毕苏醒快，可明显减少阿片类药物用量，安全可靠。

Clinical observation of Flurbiprofen axetil used for preemptive analgesia in laparoscopy operation on children

Objective： To evaluate the efficacy and safety of flurbiprofen axetil for preemptive analgesia in laparoscopy operation on children. Methods： Sixty ASA Ⅰ-Ⅱ children aged 2-5yrs, undergoing high ligation of hernial sac by laparoscopy, were randomized into two groups： control group （C） （n=30） and flurbiprofen group （F） （n=30）. Ketamine and Midazolam of Intravenous injected were used for basic anaesthesia.Control group（C） were received intravenous ketamine and fentanyl five minutes before the operation and Flurbiprofen group（F） were added flurbiprofen.Fentanyl were intermittently given during the operation according to change of vital signs.HR,R,SBP, DBP and SPO2 were measured during the operation.The awake time, restlessness and the case of received intravenous fentangyl were recorded. Result ： All of the patients were quiet during the operations and the relaxation depth of abdominal muscle was good.The effect of anaesthesia was satisfactory. Although the parameters of HR,SBP, DBP, PETCO2 of group（C） increased after establishing pneumoperitoneum（P〈0.05）,they were in range of normal level and the R was slower（P〉0.05）. There was no significant difference in SpO2 between two groups（P〉0.05）,and it was in th range from 98% to100%. The cases of received intravenous fentangyl in group（F） were fewer than in group（C） during the operations. The awake time in group（C） was longer（P〈0.05）. The rate of restlessness of group（C） was higher than group（F） （P〉0.05）. Conclusion： Flurbiprofen axetil was safe and effective for preemptive analgesia in laparoscopy operation on children and it can reduce the dosage of opium obviously. The vital signs of children were smooth during the operation .The children can fast awaking after opertian.