氟比洛芬酯超前镇痛用于乳腺癌根治术患者的临床观察

目的:探讨氟比洛芬酯超前镇痛对乳腺癌根治术患者术后疼痛以及全麻苏醒期躁动的影响。方法:选择全身麻醉下乳腺癌根治术患者(ASA I～II级)120例,随机分为A组(麻醉诱导完成后立即给予50 mg氟比洛芬酯,切口缝合完成时再给予50 mg),B组(麻醉诱导完成后立即给予100 mg氟比洛芬酯),C组(切口缝合完成时给予100 mg氟比洛芬酯)D组(对照组,切口缝合完成时换等量的生理盐水),每组30例。比较各组患者术后1,3,6,12,24 h的VAS评分,手术结束时与拔管时的心血管反应,以及全麻苏醒躁动情况。结果:3个观察组术后12 h内各时间点VAS评分均明显低于对照组(均P<0.05),其中A组各时间点均明显低于C组(均P<0.05),在1,3 h明显低于B组,而B组在1,3 h明显低于C组(均P<0.05),术后24 h的VAS评分4组间差异无统计学意义(均P>0.05);手术结束时4组间平均动脉压(MAP)和心率(HR)变化差异无统计学意义(P>0.05),但3个观察组患者拔管时的MAP,HR的变化均小于对照组(均P<0.05),其中A组变化最小,其次为B组和C组(均P<0.05),B组明显低于C组(均P<0.05);各组全麻苏醒期躁动发生率分别为:A组13.3%,B组23.3%,C组33.3%,D组43.3%,各组间的差异均有统计学意义(均P<0.05)。结论:氟比洛芬酯超前镇痛能有效减轻乳腺癌根治术患者术后早期疼痛程度、心血管反应,以及降低全麻苏醒期躁动的发生率。

Preemptive analgesic effect of flurbiprofen axetil in patients undergoing radical mastectomy

Objective:To investigate the influence of preemptive analgesia with flurbiprofen axetil on postoperative pain and agitation during the emergence from general anesthesia of the patients undergoing radical masterctomy. Methods:One hundred and twenty patients who were scheduled to undergo radical masterctomy under general anesthesia(ASA I-II) were included.The patients were randomly designated to group A(a dose of 50 mg of flurbiprofen axetil was given immediately after the induction of general anesthesia and another dose of 50 mg was given on completion of incision closure),group B(flurbiprofen axetil 100 mg was given immediately after the induction of general anesthesia),group C(flurbiprofen axetil 100 mg was given on completion of incision closure) and group D(served as the control group,and the same volume of saline was given on completion of incision closure),with 30 patients in each group.Among the groups,the visual analogue scale(VAS) scores at 1,3,6,12 and 24 h after surgery,cardiovascular responses at the end of surgery and after extubation,and incidences of emergence agitation were compared. Results:The VAS scores of the three observation groups were all significantly lower than those of the control group at each time point within 12 h after surgery(all P<0.05),in which,the VAS scores of group A were lower than those of the group C(all P<0.05) at each time points within 12 h and lower than those of group B at 1 and 3 h time points(both P<0.05),while the VAS scores of group B were significantly lower than those of the group C at 1 and 3 h time points(both P<0.05).However,the VAS scores had no significant differences among the four groups at 24 h after surgery(all P>0.05).The alterations of mean arterial pressures(MAP) and heart rates(HR) had no significant differences among the four group at the end of surgery(all P>0.05),but at the time of extubation,the alterations of both parameters of the three observation groups were all less evident than those of the control group(all P<0.05),in which group A showed the minimum changes and followed by group B and group C(all P<0.05).The incidences of emergence agitation were 13.3% in group A,23.3% in group B,33.3% in group C and 43.3% in group D,respectively,and all the differences among them had statistical significances(all P<0.05). Conclusion:Preemptive analgesia by flurbiprofen axetil for patients undergoing radical masterctomy can effectively reduce the early postoperative pain and cardiovascular responses as well as the incidence of emergence agitation.