氟比洛芬酯与复合舒芬太尼用于妇科肿瘤术后患者静脉自控镇痛的比较性研究

目的对比观察氟比洛芬酯复合舒芬太尼与单独应用舒芬太尼用于妇科肿瘤术后患者静脉自控镇痛的效果及安全性。方法妇科肿瘤手术后患者40例,随机均分为2组：舒芬太尼组,应用舒芬太尼0.03μg·kg^-1·h^-1;舒芬太尼复合氟比洛芬酯组,应用舒芬太尼0.015μg·kg^-1·h^-1与氟比洛芬酯0.075 mg·kg^-1·h^-1。记录术后PCA治疗期间患者的生命体征及2、4、8、12、24、48 h各时间点患者的镇痛和镇静评分;术后48 h内两组患者的PCA有效按压次数及是否补充镇痛药物;观察记录术后的副作用与患者对PCIA治疗的满意度。结果舒芬太尼组与舒芬太尼复合氟比洛芬酯组的VAS评分在术后48 h内各时间点无统计学差异,复合组在术后2、4 h的镇静评分明显小于舒芬太尼组（P〈0.05）;两组的PCA有效按压次数无统计学差异;复合组的恶心、呕吐的发生率明显少于舒芬太尼组（P〈0.05）;两组无1例患者在PCA期间发生呼吸抑制、皮肤瘙痒和尿潴留。结论与舒芬太尼相比较,氟比洛芬酯复合较小剂量的舒芬太尼能够安全有效地用于妇科肿瘤手术后患者自控镇痛,且副作用少。

Comparison of flurbiprofen axetil combined with or without sufentanil in patient-controlled intravenous analgesia after gynecologic tumor surgery

Objective To compare the clinical efficacy and safety of sufentanil alone or combined with flurbiprofen axetil in patient-controlled intravenous analgesia （PCIA） after gynecologic tumor surgery. Methods Forty patients, ASA Ⅰ - Ⅱ , scheduled for gynecological tumor surgery, were randomly allocated into two groups：group S and group S＋F. The patients in two groups received sufentanyl 0.03 μg·kg^-1·h^-1 and in groups S＋F received sufentanil 0. 015 μg ·kg^-1 ·h^-1 combined with flurbiprofen axetil 0. 075 mg· kg^-1· h^-1 respectively. VAS and sedation scores were recorded at 2 h,4 h,8 h,12 h, 24 h,48 h after PCIA. The change of circulation and respiration,the push times of PCA in 48 hours,supplementary analgesic administered, side effects and the patients＇ satisfactory degree were also observed. Results Compared with sufentanil group, VAS in sufentanil combined with flurbiprofen group at each point in 48 hours were no significant difference, sedation scores in group S＋F was significantly less than that in group S（P〈0.05）. The push times of PCA was no significant difference in group S compared to group S＋F（P〈0.05）. The incidence of dizzy,nausea, vomiting in group S were significantly more than that in Group S＋F. During PCIA, there was no respiratory depression and pruritus happened. Conclusion Sufentanil combined with flurbiprofen axetil and sufentanil PICA after gynecological tumor surgery are effective and safe, but less side effects in patients with sufentanil combined with flurbiprofen.