不同剂量氟比洛芬酯复合舒芬太尼术后自控静脉镇痛效果的研究

目的：观察不同剂量氟比洛芬酯复合舒芬太尼术后患者自控静脉镇痛（PCIA）的镇痛效果。方法：选择全麻下行椎弓根钉内固定术的脊柱患者121例，18~65岁，ASA Ⅰ或Ⅱ，随机分为4组。术毕均使用PCIA泵，PCIA药物配方为舒芬太尼2 μg·kg^-1+托烷司琼10 mg，加生理盐水至100 mL。其中，泵中氟比洛芬酯含量为F1组150 mg，F2组200 mg，F3组250 mg，C组为空白对照。患者术后2，4，6，12，24，48 h静息状态下VAS疼痛评分及术后6，12，24，48 h运动状态下VAS疼痛评分、镇痛泵按压次数，并对各组采用最小成本法进行药物经济学分析。结果：4组患者不同时间点VAS疼痛评分、镇痛泵按压次数及不良反应发生情况均无显著性差异（P>0.05），C组成本最低。结论：不同剂量氟比洛芬酯复合同样剂量舒芬太尼，术后镇痛效果没有明显差异，且单纯舒芬太尼治疗方案具有更大的经济学优势。

Effect of different doses of flurbiprofen combined with sufentanil on postoperative patient-controlled intravenous analgesia (PCIA)

OBJECTIVE To investigate the effects of different doses of flurbiprofen combined with sufentanil on postoperative analgesia.METHODS Totally 121 patients (aged 18-65 years old, ASA Ⅰ or Ⅱ) were scheduled for spinal surgery under general anesthesia. All patients were randomly divided into four groups. The scheme of PCIA was composed of sufentanil 2 μg·kg^-1 + tropisetron 10 mg + normal saline to 100 mL. The doses of flurbiprofen were 0, 150, 200,250 mg in group C, F1, F2, F3. Patients were observed to record VAS pain scores in resting state at postoperative 2, 4, 6, 12, 24, 48 h, VAS pain scores in moving scale at postoperative 6, 12, 24, 48 h and the number of PCIA press. And the cost minimization analysis was carried out for each group to compare the pharmacoeconomics differences.RESULTS Pain scores in resting and moving scale, the number of PCIA press and the incidence of side effects were similar in the four groups (P>0.05). And group C had the lowest cost.CONCLUSION The postoperative analgesia effect of different doses of flurbiprofen combined with same dose of sufentanil shows no significant difference. The single sufentanil treatment has the greater pharmacoeconomics advantage.