静脉氟比洛芬酯联合吗啡单次硬膜外注射用于老年患者术后镇痛的效果

目的比较静脉氟比洛芬酯联合吗啡单次硬膜外注射与硬膜外自控镇痛（PCEA）用于老年患者术后临床镇痛效果和不良反应。方法选择ASA（美国麻醉师协会）分级Ⅰ～Ⅲ级，年龄65～80岁，全身麻醉联合硬膜外行腹部手术的患者40例，随机分为两组，实验组（静脉氟比洛芬酯联合吗啡组）术后予氟比洛芬酯100～150mg联合吗啡1mg硬膜外注射；对照组（硬膜外自控镇痛组，PCEA）应用硬膜外镇痛泵，吗啡0．05mg／mL复合罗哌卡因2mg／mL背景剂量2mL／h，PCEA单次剂量2mL／次。观察患者术后12h、24h、3611和48h作VAS评分和镇静评分，记录不良反应。结果两组患者术后的视觉模拟评分（VAS）评分和Ramsay镇静评分的比较，指标差异无统计学意义（P〉0．05），两组患者术后不良反应发生情况的比较差异无统计学意义（P〉0．05）。结论静脉氟比洛芬酯联合吗啡单次硬膜外注射用于术后镇痛，可以产生良好的镇痛效果。与PCEA镇痛相比效果相当，不良反应无明显增加。

Intravenous flurbiprofen axetil combined with epidural load dose morphine for postoperative analgesia in elderly patients

Objective To compare postoperative analgesic effects of intravenous flurbiprofen axetil combined with single epidural bolus morphine with PCEA in elderly patients. Methods 40 ASA Ⅰ - Ⅲ patients aged 65 - 80 years sched- uled for elective abdominal surgery under general anesthesia combined with epidural block were randomly divided into the following two groups. Group A： after surgery, 100-150 mg flurbiprofen axetil intravenous injection combined with morphine 1 mg epidural injection was given; group B： postoperative analgesia was gained with PCEA, morphine 0.05 mg/mL mixed with ropivacaine 2 mg/mL,, continuous dose 2 mL/h, PCA 2 mL. Visual Analog Scale （VAS） and Ramsay Sedation Scale （RSS） were assessed at 12 h, 24 h, 36 h, 48 h after operation. Results There was neither significant differences in VAS and RSS, nor incidences of nausea and vomiting, rash, and itch between group A and group B. Candusion Flurbiprofen axetil intravenous injection combined with single dose morphine epidural injection could provide same analgesic effect with PCEA for elderly patients with no more side effects.