氟比洛芬酯超前镇痛对高血压患者麻醉拔管期血流动力学及术后镇痛效果的影响

目的 研究氟比洛芬酯超前镇痛对高血压患者拔管期血流动力学及术后镇痛效果的影响.方法 将60例拟行结/直肠癌根治术,ASAⅠ～Ⅲ级,要求术后镇痛的高血压患者,随机分为试验组和对照组,每组30例.试验组分别在诱导前、手术结束前给予氟比洛芬酯各50mg,对照组则分别给予等容量的0.9%氯化钠注射注,观察诱导前（T0）、拔管前（T1）、拔管时（T2）、拔管后3min（T3）、5min（T4）患者血流动力学变化和拔管期的不良反应,并记录术后不同时点患者视觉模拟评分（VAS）和PCA按压次数.结果 2组T1、T2和T3时收缩压（SBP）、舒张压（DBP）、心率（HR）均明显高于T0,差异有统计学意义（P〈0.05）;至T4时试验组恢复至麻醉前水平,差异无统计学意义（P〉0.05）,而对照组仍较T0高,差异有统计学意义（P〈0.05）.与对照组相比,试验组T1～T4时点SBP、DBP、HR值明显降低,差异有统计学意义（P〈0.05）.试验组躁动及咽喉痛的发生率较对照组明显减少.试验组在术后1、6h的VAS评分较对照组明显降低,试验组PCA按压次数较对照组明显减少,差异均有统计学意义（P〈0.05）.结论 氟比洛芬酯超前镇痛可减少高血压患者围拔管期的血流动力学波动,不影响患者的苏醒,并能降低拔管后不良反应的发生率,提高术后镇痛效果.

Effects of preemptive analgesia with flurbiprofen axetil on hemodynamics during extubation period and postoperative analgesia in hypertensive patients

Objective To study the effects of preemptive analgesia with lurbiprofen axetil on hemodynamics during extubation period and postoperative analgesia in hypertensive patients. Methods 60 cases of ASA I - Ill patients with hyper- tension undergoing open radical resection for colorectal cancer and asking for patient-controlled intravenous analgesia were ran- domly divided into experimental group and control group,30 patients in each group. The experimental group received flurbipro- fen axetil 50mg respectively before induction and the end of operation. While the control group was given same volume of sa- line. Adverse reactions during extubation period and the changes of hemodynamics at premeditation （ To ）, before the tracheal extubation（ T1 ）, tracheal extubation（ T2 ）, and 3min（ T3 ） ,5min（ T4 ） after the tracheal extubation were observed. Postopera- tive analgesia efficacy was assessed by visual analogue scale （VAS） and PCA pressing times, which were recorded in different time. Results Changes of SBP,DBP, HR：Compared with To, the data of 2 groups was increased significantly at T1 ,T2 and T3, the difference was statistically significant （P 〈 0.05）, but the data was recovered at T4 in experimental group, the difference was no statistically significant（P 〉0.05）,in control group still significantly higher, the difference was statistically significant （ P 〈0.05）. Compared with control group,the data of experimental group were lower from T1 to T4, the difference was statisti- cally significant （ P 〈 0.05 ）. Comparison of adverse reaction： The incidence of postoperative restlessness and threat pain in ex- perimental group were obviously reduced compared with control group, the difference was statistically significant （ P 〈 0.05 ）. Comparison the effect of postoperative analgesia：VAS were lower in experimental group at 1,6h compared with control group, the difference was statistically significant （P 〈 0.05）. Compared with control group , PCA pressing times were obviously less in experimental group, the difference was statistically significant （P 〉 0.05）. Conclusion Preemptive analgesia with flurbiprofen axetil can obviously reduce the hemodynamic change during extubation period in hypertensive patients, and won＇t influence pa- tient＇s recovery. Furthermore, it can reduce the adverse effect and enhance the effect of postoperative analgesia.