氟比洛芬酯联合舒芬太尼用于高血压病患者术后静脉镇痛的疗效观察

目的观察氟比洛芬酯联合舒芬太尼用于高血压患者术后静脉镇痛的疗效。方法选择合并轻中度高血压病择期开腹手术患者60例，全麻手术后完全随机分为A、B、C3组，每组各20例。A组应用舒芬太尼100mg＋生理盐水至100ml；B组应用舒芬太尼50μg＋氟比洛芬酯100mg＋生理盐水至100ml；C组静脉单次注射哌替啶。分别记录3组手术前（T0）、术毕气管拔管后10min、术后1、6、12、24、48h的HR、BP、SPO2以及视觉模拟（VAS）和Ramesay镇静评分。观察3组术后镇痛的疗效和降压药应用的情况，以及恶心、呕吐、嗜睡、呼吸抑制的发生率。结果A、B2组术后镇痛效果良好，术后1、6、12、24h的VAS评分[分别为A组（2．1±0．7）分、（2．2±0．5）分、（2．3±0．8）分、（1．4±0．3）分、（1．6±0．5）分，B组（2．2±0．4）分、（2．1±0．3）分、（2．2±0．5）分、（1．3±0．6）分]均低于C组[（7．3±0．8）分、（6．8±0．7）分、（8．5±0．2）分、（6．6±0．4）分、（6．7±0．7）分]，差异有统计学意义（P〈0．05）；镇静评分A组〉B组〉C组；A、B和C组应用佩尔地平降压的患者分别为5％、10％和45％。结论氟比洛芬酯联合舒芬太尼静脉镇痛能有效地减轻患者术后疼痛，而且不良反应少，恶心呕吐的发生率低，少有呼吸抑制，并能有效地降低高血压患者术后血压水平并减少降压药的使用。

The clinical observation of postoperative analgesia with flurbiprofen axetil injection combined with sufentanyl

Objectives To study the analgesia effect of flurbiprofen axetil injection combined with sufenta-nyl. Methods Sixty patients with 1-2 degree(WHO/ISH) hypertension were randomly divided into 3 groups with 20 cases in each group after geneal anaesthesia. Group A was given Sufentanyl 100 μg diluted to 100 ml via PCIA.Group B was given sufentanyl 50μg and flurbiprofen axetil injection 100 mg diluted to 100 ml via PCIA. In Group C only pohtidine was given. The efficacy and complications were observed. Heart rate(HR), Blood pressure(BP),Saturation of pulse oxygen (SPO_2) , Visual Analog Scale(VAS) and Ramesay score at defined time points (before anesthesia and 10 min, 1,6,12,24,48 h after anesthesia) were compared. Results The VAS of group C was high-er than those of group A and B 1,6,12,24 h after anesthesia (all P < 0.05). Ramesay score: A > B > C. The rate of using other drugs to control BP was as follows: Group A: 5%, Group B:10%, Group C: more than 45%.Conclusions Intravenous postoperative analgesia using flurbiprofen axeyii injection combined with sufentanyl has a better analgesic effect in patients than using Pethiding alone. The new strategy can reduce sufentanyl usage and the side effects and relieve changes of haemodvnamics.