50例舒芬太尼联合氟比洛芬酯对腹部手术后PCIA的镇痛效果及安全性分析

目的：观察和评估舒芬太尼联合氟比洛芬酯对腹部手术后患者静脉自控镇痛（PCIA）的镇痛效果、对CRP、IL-6水平的影响和安全性。方法：选取择期行腹部手术的患者100例，均采用静吸复合全麻，术后行静脉自控镇痛。随机分为观察组和对照组各50例，观察组采用舒芬太尼75μg+氟比洛芬酯100 mg+0.9%氯化钠溶液+昂丹司琼8 mg；对照组采用舒芬太尼150μg+0.9%氯化钠溶液+昂丹司琼8 mg。对比分析两组患者术后24 h内VAS评分、Ramesay镇静评分、舒芬太尼的使用总量、中位PCIA的按压次数、不良反应的发生率、CRP和IL-6水平，以及满意度评分。结果：观察组患者的VAS评分，Ramesay镇静评分，舒芬太尼的使用总量和不良反应的发生率低于对照组患者（P＞0.05）。两组患者术后CRP和IL-6水平明显高于术前，且观察组患者术后CRP和IL-6水平明显低于对照组患者（P＜0.01）；观察组患者的满意度明显高于对照组患者（P＜0.05）。结论：舒芬太尼联合氟比洛芬酯对腹部手术后PCIA效果较好，能减少患者舒芬太尼的使用量，保证安全有效的镇痛效果，有效降低手术对患者机体的应激反应的影响，减轻炎症反应，减少不良反应的发生率，提高患者的满意度，安全性较高。

Analysis of analgesic effect and safety of sufentanil combined with lfurbiprofen in the treatment of 50 cases of PCIA after abdominal surgery

To evaluate the analgesic effect of sufentanil combined with lfurbiprofen on patient-controlled intravenous analgesia (PCIA) and their effects on C-reactive protein (CRP) and interleukin-6 (IL-6) levels after abdominal surgery and safety. Methods:One hundreds cases of patients who underwent the elective abdominal surgery by intravenous-inhalation anesthesia combined with general anesthesia and the postoperative intravenous analgesia were selected and randomly divided into an observation group and a control group with 50 cases each. The observation group was given sufentanil 75μg+lfurbiprofen axetil 100 mg+0.9%sodium chloride solution+ondansetron 8 mg while the control group was given sufentanil 150μg+0.9%sodium chloride solution+ondansetron 8 mg. The pain visual analog scale (VAS), ramesay sedation score, total amount of sufentanil used, PCIA pressing times, incidence of adverse reactions and CRP and IL-6 levels within postoperative 24 h and satisfaction scores were compared between two groups. Results:VAS score, Ramesay sedation score, the total amount of sufentanil used and incidence of adverse reactions were signiifcantly lower in the observation group than in the control group (P>0.05). Postoperative CRP and IL-6 levels were signiifcantly higher than preoperative ones in both groups and signiifcantly lower in the observation group than in the control group (P<0.01). The satisfaction was signiifcantly higher in the observation group than in the control group (P<0.05). Conclusion:Sufentanil combined with lfurbiprofen has good effect in the treatment of postoperative PCIA, can ensure safe and effective analgesic effect, effectively reduce the amount of sufentanil used, the impact of surgery on the body’s stress response, the inlfammatory response and the incidence of adverse reactions, and improve patient’s satisfaction with higher safety.