氟比洛芬酯术前术毕静注对上腹部手术镇痛效果的影响

目的观察氟比洛芬酯术前术毕用于上腹部手术对术后镇痛效应的影响。方法 60例ASAⅠ-Ⅲ级择期上腹部手术患者,术后使用一次性微量镇痛泵,随机均分为三组:Ⅰ组术后用氟比洛芬酯100 mg;Ⅱ组术前用氟比洛芬酯100 mg、Ⅲ组术前用氟比洛芬酯50 mg+术毕静注入50 mg,术毕三组患者清醒均使用静脉镇痛PCIA泵芬太尼10μg/kg+雷默司琼0.6 mg加生理盐水到100 ml行静脉镇痛.记录各组疼痛评分(视觉模拟评分VAS)、生命体征的变化,比较镇痛满意度、不良反应的出现情况。结果三组患者性别、年龄、体重、手术时间及生命体征的差异均无统计学意义。术后4 hⅠ组VAS显著高于Ⅲ组(P0.05),8 hⅠ组的VAS显著高于Ⅱ组及Ⅲ组(P0.05),术后122、4、48 h三组VAS差异无统计学意义。各点Ⅲ组VAS均低于Ⅱ组,但差异均无统计学意义。Ⅰ组和Ⅱ组的恶心发生率较高,但与Ⅲ组差异无统计学意义。三组的呕吐以及嗜睡情况相似,差异无统计学意义。Ⅰ组和Ⅱ组头晕的发生明显多于Ⅲ组(P0.05)。由于术后留置导尿没有发生腹部胀满、排尿困难等不良反应。结论分别于术前术毕使用氟比洛芬酯50 mg进行超前镇痛及追加药物镇痛能明显降低开腹术后疼痛,是一种很好的镇痛方法。

The effect of pre-and post-operative intravenous injection of flurbiprofen axetil on the analgsia of upper abdominal surgery

Objective To observe the effect of pre-and post-operative intravenous injection of flurbiprofen axetil on the analgsia of upper abdominal surgery.Methods Sixty patients,ASA Ⅰ to Ⅲ,scheduled for elective upper abdominal operation and ready to use PICA after the surgery,were randomized into 3 groups.Group Ⅰ were injected flurbiprofen axetil 100 mg postsurgically whereas Group Ⅱ presurgically at the same dose.Group Ⅲ were,respectively,injected flurbiprofen axetil 50 mg pre-and post-surgery.The patients in three groups＇,all sobered after the surgery,were infused with PICA to alleviate the pain caused by the operation,each containing fentanyl 10 μg/kg,ramosetron 0.6 mg,and all added normal saline to 100 ml.Outcome measures were the patients＇ preception of pain on a visual analogue scale（VSA）,changes in vital signs,the satisfaction of the alleviation,and the side effects.Results Three groups of patients with gender,age,weight,operation time and vital signs were no statistical significant difference.4 hours after the operation,Group I＇s VSA was remarkably higher than that of Group Ⅲ＇s（P〈0.05）.8 hours after the surgery the VSA of Group Ⅰ＇s was significantly higher than the rest of the two Groups＇（P〈0.05）.On hour 12,24 and 48 after the operation,there was almost no statistical difference in VAS.Each time,Group Ⅲ＇s VSA was lower than Group Ⅱ＇s,but that the differences was not instructive either.The incidence of nausea in Group Ⅰ and Ⅱ was in a high level,however,compared with Group Ⅲ the variation was insiginificant.Similar was the condition of sickness and hypersomnia,bascially no difference among three groups.The occurance of dizziness in Group Ⅰ and Ⅱ was significantly higher than Group Ⅲ（P〈0.05）.Due to Catheterization postoperatively,no abdominal distension and dysuria happened.Conclusion 50 mg flurbiprofen axetil respectively injceted before and after the operation to the preemptive analgesia with additional drugs used to alleviate the pain would obviously lower the abdominal pain after the surgery.