氟比洛芬酯复合吗啡硬膜外腔镇痛对妇科术后镇痛效果的观察

目的：探讨氟比洛芬酯复合吗啡硬膜外腔多模式镇痛对妇科术后镇痛效果的观察。方法：选择ASAⅠ～Ⅱ级、择期全子宫切除患者90例,随机等分为A、B、C组（各30例）。A组：采用硬膜外腔自控镇痛（吗啡5mg＋罗哌卡因125mg＋氟哌利多2.5mg）,术毕时连接PCEA泵;B组：采用吗啡硬膜外腔镇痛,术毕时硬膜外注射吗啡2mg＋氟哌利多1.5mg,18h后硬膜外再追加吗啡2mg,拔出硬膜外导管;C组：采用吗啡单次硬膜外腔镇痛术复合氟比洛芬酯静脉镇痛,术毕硬膜外注射吗啡2mg＋氟哌利多1.5mg后拔出硬膜外导管,18h后静脉注射氟比洛芬酯100mg,8h后重复注射氟比洛芬酯100mg。观察记录3组的镇痛效果（VAS评分）和不良反应。结果：3组均能取得良好的镇痛效果,VAS评分无显著性差异（P〉0.05）。C组恶心、呕吐、皮肤瘙痒和尿潴留等不良反应的发生率组明显少于A、B组（P〈0.05）。结论：3组均取得了良好的镇痛效果,但是氟比洛芬酯复合吗啡硬膜外镇痛方式可明显减少不良反应的发生。

Analgesic Effects of Flurbiprofen Axetil Combined with Morphine in Patients after Undergoing Gynecological Surgery

OBJECTIVE： To evaluate the postoperative analgesic effects of flurbiprofen Axetil combined with morphine （ injected into epidural space） in patients after gynecilogical operation. METHODS： A total of ninety patients （ASA I or II grade） undergoing total hysterectomy were randomly divided into A,B,C groups of 30 each： Group A received patient controlled epidural analgesia,PCEA （ morphine 5 mg ＋ ropivacaine 125 mg ＋ droperidol 2. 5 mg） with PCEA pump connected to patients after the completion of surgery; Group B received epidural analgesia in which morphine 2 mg and droperidol 1. 5 mg were given after completion of surgery,and then 2 mg morphine was given again at 18 hours followed by withdrawal of epidural catheter; Group C received epidural analgesia with single dose morphine combined with intravenous flurbiprofen Axetil for intravenous analgesia in which epidural injection of morphine 2 mg plus droperidol 1. 5 mg were performed followed by withdrawal of epidural catheter,and flurbiprofen axetil 100 mg were intravenous injected again at 18 and 26 hours after operation. The analgesic efficacy （VAS scores） and side effects of the 3 groups were recorded. RESULTS： There were no statistical differences in VAS scores among the three groups （P 0. 05）. The incidences of nausea,vomiting,itch of skin and urinary retention in group C were significantly lower than in group A and B （P 0. 05）. CONCLUSION： The postoperative epidural analgesic effects in all three groups are satisfactory,but there were fewer side effects in epidural analgesia with flurbiprofen axetil combined with morphine.