镇痛药不同给药时机对中等面积二度烧伤患者换药镇痛效果的影响

目的 观察镇痛药的不同给药时机对烧伤换药所产生的疼痛强度及持续时间的影响。方法 男性下肢 烧伤患者40例按照随机数字表法均分为前换药组（Pre组）与后换药组（Post组）。Pre组患者于换药前30 min给予氟 比洛芬酯50 mg，Post组患者待换药结束后立刻给予相同剂量的氟比洛芬酯，记录2组患者换药过程中心率（HR）、收 缩压（SBP）、舒张压（DBP）及主观疼痛评分（数字评分法，NRS）的最高值（max）。同时记录2组患者自换药后0.5、1、 2、4、8、14及24 h的HR、SBP、DBP、NRS值及患者恢复至轻度疼痛时所需时间。结果 与Post组比较，Pre组在换药 过程中及换药结束后1 h内的HR、SBP及DBP均较低，4 h、14 h时SBP低于Post组，8 h时DBP低于Post组（P＜0.05）； 与Post组比较，Pre组在换药过程中及换药结束后4 h内的NRS均较低（P＜0.05）；与Post组比较，Pre组在换药结束后 可更快地恢复至轻度疼痛状态（P＜0.05）。结论 在烧伤换药前30 min给予镇痛药可明显减轻患者换药疼痛强度及 换药后疼痛持续时间。

Study on the analgesic effects of different administration timing points on dressing change in patients with moderate second degree burn

Objective To observe the effects of different administration timing of analgesics on the intensity and duration of pain caused by dressing changes on burn. Methods Forty male patients with lower limb burn were randomly divided into the experimental group (Pre group) and the control group (Post Group). Patients in Pre group were given flurbiprofen axetil 50 mg 30 minutes before dressing change, and patients in Post group were given flurbiprofen axetil with the same dose immediately after dressing change. The maximum heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and subjective pain score (numerical rating scale, NRS) were recorded before dressing change, and at the time points of 0.5, 1, 2, 4, 8, 14 and 24 hours after dressing change. The simultaneous assessment of NRS was also recorded. Results Compared with the Post group, HR, SBP and DBP were lower in the Pre group during dressing change and 1 hour after dressing change (P＜0.05). SBP was lower at 4,14 h and DBP at 8 h was also lower in the Post group (P＜ 0.05). Compared with the Post group, NRS was lower during dressing change and within 4 hours after dressing change in the Pre group (P＜0.05). Compared with the Post group, patients in the Pre group recovered to mild pain more quickly after dressing change (P＜0.05). Conclusion Thirty minutes administration of analgesics before dressing change can significantly reduce the intensity of dressing change pain and the duration of pain after dressing change.