氟比洛芬酯联合吗啡用于开胸手术的超前镇痛效果研究

目的研究氟比洛芬酯联合吗啡在开胸手术前使用是否有超前镇痛的效果,并对比其不良反应。方法我院ASAⅠ～Ⅱ级择期行开胸手术患者60例,按随机双盲原则分为Ⅰ、Ⅱ、Ⅲ3组,各20例。Ⅰ组采用术前氟比洛芬酯,术后吗啡的镇痛方法;Ⅱ组采用术后氟比洛芬酯联合吗啡镇痛;Ⅲ组采用术后吗啡镇痛。观察各组术后1、2、4、8、12h的视觉模拟评分（VAS）和不良反应。结果手术过程中3组患者都有较好的镇痛效果,术后1、2、4、8hVAS评分Ⅲ组明显高于Ⅰ、Ⅱ组;且术后4h内VAS评分Ⅱ组高于Ⅰ组,差异均有统计学意义（P〈0.05）;术后12hVAS评分3组间比较差异无统计学意义（P〉0.05）。不良反应Ⅰ组和Ⅱ组无差别,均明显低于Ⅲ组,差异有统计学意义（P〈0.05）。结论氟比洛芬酯与吗啡复合应用可以增强镇痛效果,而其不良反应的发生率较低。

Preemptive analgesia effects of flurbiprofen axetil combined morphine for thoracic surgery

Objective To study the preemptive analgesia effect of flurbiprofen axetil combined morphine used before the open thoracotomy,and compared their adverse reactions.Methods ASA Ⅰ~Ⅱ grade patients（60 cases）who undergoing thoracic surgery were randomly divided into Ⅰ,Ⅱ,Ⅲ three groups with double-blind principle,each of 20 cases.Ⅰ group were treated with flurbiprofen axetils at preoperative and at postoperative used morphine to analgesia;Ⅱ group were treated with flurbiprofen axetil combined morphine to analgesia at postoperative;Ⅲ group were treated with morphine to analgesia at postoperative.Observed the visual analogue scale（VAS）and adverse reactions after 1,2,4,8,12 hours in each group.Results All patients had a better analgesic effect,the 1,2,4,8 hours VAS score in group Ⅲ was significantly higher than that in group Ⅰand group Ⅱ ,and the VAS score after 4 hours in group Ⅱ was higher than that in group Ⅰ,the differences were statistically significant（P0.05）;After 12 hours,the VAS score between these three groups was no significant difference（P0.05）.There was no difference between group Ⅰ and Ⅱ in adverse reactions,and both significantly lower than that in group Ⅲ,the difference was statistically significant（P0.05）.Conclusion Flurbiprofen Axetil and morphine composite application can enhance the analgesic effect and the incidence of adverse reactions is lower.