氟比洛芬酯与吗啡联合用于剖宫产术后镇痛的临床研究

目的观察氟比洛芬酯与吗啡联合用于剖宫产术后镇痛是否有协同作用。方法选择100例剖宫产手术的患者,随机双盲分为吗啡组（A组）和氟比洛芬酯-吗啡组（B组）,每组各50例。A组患者在缝皮结束后,将2.0 mg吗啡＋4.5 mL生理盐水注入硬膜外腔;B组患者于麻醉前将1.0 mg/kg氟比洛芬酯＋500 mL复方乳酸钠林格液在20 min通过静脉注入体内,同时在缝皮结束后于硬膜外腔处以同样方法注入与A组相同剂量的吗啡。采用视觉模拟评分法（VAS）观察术后4、8、16、20、24、28、32和36 h时间点的镇痛效果,同时记录镇痛持续时间以及镇痛过程中出现的不良反应。结果 B组患者在术后20、24、28、32 h的评分VAS低于A组（P〈0.05）。B组患者的镇痛持续时间显著长于A组,两组患者比较差异有统计学意义（P〈0.05）。两组患者尿潴留、恶心呕吐、皮肤瘙痒等不良反应发生率相比差异无统计学意义（P〉0.05）。结论静脉滴注氟比洛芬酯与硬膜外腔单次注入吗啡,联合用于术后镇痛具有协同作用。与单独应用吗啡相比,可延长术后镇痛的持续时间,降低疼痛的评分。二者联合应用,不能减少不良反应的发生率。

Effects of the combination of Flurbiprofen Axetil and Morphine on postoperative analgesia in cesarean section patients

Objective To observe whether the synergistic effect of Flurbiprofen Axetil combined with Morphine for postoperative analgesia after cesarean section.Methods 100 cases of cesarean section operation patients were divided into Morphine group（group A） and Flurbiprofen Ester-Morphine group（group B） randomly and double-blindly,50 cases in each group.All patients received 2.0 mg morphine＋4.5 mL normal saline which were injected into the epidural space injection after skin suture,but group B was given 1.0 mg/kg flurbiprofen axetil＋500 mL compound sodium lactate Ringer＇s solution which were injected by intravenous injection in 20 min before anesthesia.Then the VAS scores of all patients at postoperative 4,8,16,20,24,28,32 and 36 h were evaluated,and the duration of analgesia,ddverse reactions were recorded.Results The VAS scores of group B at postoperative 20,24,28 and 32 h were statistically lower than those of group A（P 0.05）.The duration of analgesia of group B was statistically longer than that of group A（P 0.05）.There were no statistical differences in the incidence of adverse reactions including urinary retention,nausea and vomiting,itchy skin between group A and group B（P 0.05）.Conclusion Intravenous Flurbiprofen Axetil versus epidural single injection of Morphine for postoperative analgesia have synergistic effect.With a separate application compared with morphine,which prolongs postoperative analgesia duration,lower pain score.The combination of the two can not reduce the incidence rate of adverse reaction.