不同时点应用氟比洛芬酯对妇科手术患者术后镇痛效果的影响

目的观察不同时点应用氟比洛芬酯对妇科手术患者术后镇痛效果的影响。方法80例择期行妇科手术的患者，随机分为4组，每组各20例，A组为对照组，B、C、D组分别于切皮前、缝皮时、切皮前和缝皮时均静脉给予氟比洛芬酯50mg。术毕4组开启同样配方的静脉自控镇痛泵。分别记录患者术后1h（T1）、4h（T2）、8h（T3）、12h（T4）、24h（T5）、48h（T6）的VAS镇痛评分、Ramesay镇静评分、术后24h内患者PCA按压次数及不良反应。结果B、C、D组在T1、T2、T3、T4时间点的VAS评分均显著低于A组（P〈0．05），在T1、T2、T3时间点的Ramesay评分均显著高于A组（P〈0．05）；D组在T1、T2、T3、T4时间点的VAS评分均显著低于B、患者静脉自控镇痛c组（P〈0．05），在T1、T2、T3时间点的Ramesay评分均显著高于B、c组（P〈0．05）。B、C、D组患者在术后24h内的PCIA泵按压次数均显著低于A组（P〈0．05），D组患者在术后24h内患者静脉自控镇痛（PCIA）按压次数均显著低于B、C组（P〈0．05），而恶心、呕吐、皮肤瘙痒及呼吸抑制等不良反应各组差异无统计学意义。结论氟比洛芬酯有较强的镇痛作用，于手术切皮前和缝皮时均静脉给药，获最佳妇科手术术后的镇痛效果。

Analgesic effect of flurbiprofen axetil used for post-gynecological surgery patients

Objective To observe the analgesic effect of flurbiprofen axetil used for post-gynecological surgery patients in different time points. Methods A total of 80 patients of gynecological surgery were randomly divided into four groups in 20 patients each. Group A was the control group. Group B was given 50 mg flurbiprofen axetil intravenously before incising the skin. Group C was given 50 mg flubiprofen axetil intravenously before suturing the skin. Group D was given 50 mg flubiprofen axetil intravenously both before incising and suturing the skin. All the four groups received the same patient controlled intravenous analgesia （PCIA）. VAS pain score and Ramesay sedation score were recorded at 1 h （Tl）, 4 h （T2）, 8 h （T3）, 12 h （T4）, 24 h （Ts）, 48 h （T6） after operation. The pressing times of PCIA and adverse reactions were also recorded at 24 h after operation. Results VAS scores of group B, C and D were significantly lower than those of group A at T1, T2, T3 and T4 （P〈0.05）. Ramesay scores of group B, C and D were significantly higher than group A at T1, T2 and T3 （P〈0.05）. VAS scores of group D were significantly lower than those of group B and C at T1, T2, T3 and T4 （P〈0.05）. Ramesay scores of group D were significantly higher than group B and C at T1, T2 and T3 （P〈 0.05）. The times of the PCIA 24 h after operation in group A were significantly more than group B, C and D （P〈0.05）, and D group were significantly less than group B and C （P〈0.05）.While nausea, vomiting, pruritus and respiratory depression and other adverse reactions showed no significant difference. Conclusion Flurbiprofen axetil has a strong analgesic effect for post-gynecological surgery patients.