氟比洛芬酯对中重度术后疼痛患者吗啡用量及效果的影响

目的 比较氟比洛芬酯联合吗啡与单纯吗啡静脉术后镇痛用于中重度术后疼痛的临床效应. 方法 择期行腹部和胸部手术患者60例,随机分为3组,每组20例. M组：术后镇痛吗啡50 mg＋0.9%氯化钠注射液共100 mL; F1组：氟比洛芬酯50 mg超前镇痛,术后镇痛吗啡50 mg＋0.9%氯化钠注射液共100 mL; F2组：氟比洛芬酯100 mg＋吗啡50 mg＋0.9%氯化钠注射液共100 mL. 3组术后镇痛（PCA）的设置：PCA 2 mL,锁定时间5 min,每小时极量20 mL. 观察患者术后2,8,24 h的疼痛评分、吗啡用量及不良反应. 结果 3组患者术后2,8,24 h的静息痛视觉模拟评分（VAS）和活动痛VAS评分差异无显著性（P>0.05）; 24 h吗啡用量F1、F2组有减少趋势,但差异无显著性（P>0.05）; 恶心、呕吐的发生率也差异无显著性（P>0.05）. 3组中均无呼吸抑制和胃肠道出血发生. 结论 对于中重度术后疼痛的中老年患者,氟比洛芬酯50 mg超前镇痛或者镇痛泵中吗啡伍用氟比洛芬酯100 mg,均可取得较好镇痛效果,并可减少吗啡用量,但并不显著.

The Influence of Flurbiprofen Axetil on Doses and Effect of Morphine for Patients with Moderate to Severe Postoperative Pain

Objective To compare analgesic efficacy on postoperative analgesia with flurbiprofen axetil combined morphine and with morphine alone.Methods Sixty patients undergoing elective abdominal or thoracic surgery were randomly divided into three groups with twenty patients each.Group M was given morphine 50 mg diluted to 100 mL via PCA after surgery.Group F1 was administrated with flurbiprofen axetil before operation,and morphine 50 mg diluted to 100 mL via PCA after surgery.Group F2 was given flurbiprofen axetil plus morphine 50 mg diluted to 100 mL via PCA after surgery.The set of PCA were the same for three groups,bolus 2 mL,lock time 5 min,maximum volume 20 mL per hour.VAS score was assessed at 2 h,8 h and 24 h postoperative,doses of morphine needed at 24 h and side effects were recorded.Results There was no significant difference in VAS score at 2,8 and 24 h among three groups(P>0.05).Doses or morphine needed in F1 group and F2 group were a little lower than that in M group,but there were no significant difference among three groups(P>0.05).There were no significant difference in side effects either(P>0.05).No respiratory depression or gastrointestinal bleeding occurred in three groups.Conclusion Preemptive with flurbiprofen aextil 50 mg and flurbiprofen axetil 100 mg administrated via PCA both show good analgesic effect,and can reduce morphine requirement for middle to old age patients with moderate to severe postoperative pain,though without significant difference in dose.