氟比洛芬酯复合芬太尼用于老年人前列腺电切术术后静脉镇痛的研究

目的评价TUVP术患者术后使用氟比洛芬酯复合芬太尼静脉镇痛（PCIA）的效果。方法60例择期行TUVP手术患者随机均分为四组，镇痛方法为：A组：芬太尼0．02mg／kg＋恩丹司琼8mg，术后镇痛；B组：芬太尼0．01mg／kg＋恩丹司琼8mg，术后镇痛；C组：手术前15min缓慢静脉推注氟比洛芬酯50mg，芬太尼0．01mg／kg＋恩丹司琼8mg，术后镇痛；D组：术毕缓慢静脉推注氟比洛芬酯50mg，术后芬太尼0．01mg／kg＋恩丹司琼8mg，术后镇痛。镇痛药物均用生理盐水稀释至100ml。比较术后VAS评分和镇静评分（SS）以及恶心、呕吐、皮肤瘙痒、呼吸抑制等不良反应的发生率。结果术后2h四组间的VAS无统计学差异，而4、12h时A、C、D组的VAS显著低于B组（P〈0．05），12h后四组间的VAS无统计学差异；术后24h时A组SS高于其他三组（P〈0．05）具有统计学差异，4h以后四组间的ss差异无显著性。A组恶心、呕吐的发生率显著高于其他三组（P〈0．05），B、C、D组组间差异无统计学意义。结论TUVP术术前和术毕静脉缓慢注射氟比洛芬酯50mg，然后以0．01mg／kg芬太尼PGIA维持48h镇痛效果良好，阿片类药物不良反应明显减少，安全有效。

Post- operative analgesia with flurbiprofen and fentainly treatment after transurethral prostatectomy

Objective To study the effect and side effect of post operative PICA with flurbiprofen and fentainly treatment after transurethral prostateetomy. Methods 60 cases of such patient were divided into four groups. Group A, fentainly 0. 02 mg/kg ＋ endotoxin 8 mg ＋0. 9% NaCl for post-operative analgesia;group B, fentainly 0.01 mg/kg ＋ endotoxin 8 mg ＋0. 9% NaCl for post-operative analgesia;group C, flurbiprofen axetil 50 mg in 15 minutes before operation and fentainly 0. O1 mg/kg ＋ endotoxin 8 mg ＋0. 9% NaCI for post- operative analgesia;group D ,flurbiprofen axetil 50 mg after operation and fentairdy 0.01 mg/kg ＋ endotoxin 8 mg＋ 0.9% NaCl for post-operative analgesia. The visual analogue scale （VAS） , sedation score （SS）and incidence of side effects were recorded during the period of postoperative 2 h ,4 h , 12 h,24 h. Results In 2 h after operation, the VAS was similar in all the four groups. In 4 h, 12 h after operation, the VAS of groupB was significantly higher than those of group A, C, D （ P 〈 0. 05 ） , which became similar in all the four groups after another 12 h. In 4 h, 12 h after operation, the SS was similar in all the four groups. In 24 h after operation, the SS of groupA was significantly higher than those of group B, C, D. The incidence of nausea, vomiting in group A was significandy higher than those of group B, C, D （ P 〈 0. 05 ） , which became similar in all the three groups B, C, D. Conclusion Postoperative analgesia with intravenous flurbiprofen axetil injection combined with fentanyl has a better analgesic effect than fentanyl alone in patients. The strategy can reduce fentanl usage and side effects.