氟比洛芬酯对乳腺癌改良根治术患者术后镇痛效果的影响

目的探讨术前应用氟比洛芬酯对乳腺癌改良根治术患者血液前列腺素E2（PGE2）及术后镇痛效果的影响。方法32例ASAI～Ⅱ级拟在全麻下行乳腺癌改良根治术患者，随机分为2组（n=16）：氟比洛芬酯组（F组）和对照组（C组）。F组切皮前15min静脉缓注氟比洛芬酯1．0mg／kg；C组切皮前15min静脉缓注等容量生理盐水。于麻醉诱导前（T1）、手术1h（T2）、术毕（T3）、术后2h（T4）、术后24（T5）采静脉血，采用放射免疫法测定血浆PGE2浓度，并采用视觉模拟评分法（VAS）分别记录患者术后1h、2h、4h、6h、12h、24h的疼痛评分。结果两组患者的年龄、体重、手术时间、术中出血量等一般情况无显著性差异仍0．05）。术后1h、2h、4h，F组的VAS评分低于C组（P〈0．05），术后6h、12h、24h两组VAS评分比较差异无显著性（P〉0．05）。F组PGE2水平在T2-4时间点与T1相比差异无统计学意义（P〉0．05），C组PGE2水平在T2-4时间点与Tl比较均升高（P〈0．05）。与C组比较，F组在T2-4时间点PGE2水平降低（P〈0．05）。结论术前应用氟比洛芬酯可抑制PGE2的产生，减轻乳腺癌改良根治术患者术后早期疼痛。

Effects of flurbiprofen axetil injection before operation on prostaglandin E2 and postoperative analgesia in patients undergoing modified radical mastectomy

Objective To discuss the effects of flurbiprofen axetil injection before operation on prostaglandin E2 and postoperative analgesia in patients undergoing modified radical mastectomy.nethods Thirty-two ASA I -Ⅱ patients undergoing elective modified radical mastectomy under general anesthesia were randomly divided into 2 groups：I control group （C） and Ⅱ flurbiprofen group （F）. The group F received flurbiprofen axetil lmg/kg intravenously at 15min before skin incision.Blood samples were taken immediately before induction of anesthesia（T1）,at lh of operation （T2）,immediately after the end of operation（T3）,2h and 24h after operation（T4-5） for determination of plasma level of PGE2.Postoperative analgesia efficacy was assessed by visual analoge scales（VAS）at 1h,2h,4h, 6h, 12h and 24h after surgery.Results The VAS score was significantly lower in group F than in group C at lh,2h,4h after operation. In the two group ,there were no significant differences in the VAS score at 6h, 12h ,24h after operation.In group F,there were no significant changes in the level of PGE2 at T2-T4 as compared with the value at T,.In group C the level of PGE2 was significantly increased at T2-T4 as compared with the value at T1 and was significantly higher than in group F.Conelusion Preoperative flurbiprofen axetil can inhibit the production of PGE2 and suppress immediate postoperative pain in patients undergoing modified radical mastectomy.