氟比洛芬酯复合芬太尼用于术后静脉镇痛的效果观察

［摘要］目的比较氟比洛芬酯复合小剂量芬太尼与单纯芬太尼用于子宫全切术后患者自控静脉镇痛的临床效果。方法选择全麻下子宫全切术患者120例，术后行患者自控静脉镇痛（PCIA），并根据不同的用药方法随机分为4组，每组30例。A组：芬太尼1 mg+0.9%氯化钠（NaCl）注射液共100 mL；B组：芬太尼0.5 mg+0.9%NaCl注射液共100 mL；C组：氟比洛芬酯50 mg+芬太尼0.5 mg+0.9%NaCl注射液共100 mL；D组：氟比洛芬酯 100 mg+芬太尼0.375 mg+0.9%NaCl注射液共100 mL。术后24 h内采用视觉模拟评分（VAS）、PCIA按压次数观察各组镇痛效应及恶心呕吐、嗜睡等不良反应的发生率。结果B组术后2 h时的VAS评分显著高于A、C和D组（P＜0.05），而2 h后的VAS4组间差异无显著性（P＞0.05）。24 h内的PCIA按压次数B组显著多于A、C和D组（P＜0.05）。B、C和D组中恶心、呕吐、皮肤瘙痒及嗜睡等不良反应的发生率显著低于A组（P＜0.05）。镇痛期间无呼吸抑制、异常出血等并发症。结论氟比洛芬酯复合小剂量芬太尼用于子宫全切术后静脉镇痛可取得满意的镇痛效果，并能减少芬太尼的用量及不良反应的发生率。

The Clinical Effect of Flurbiprofen Axeyil Combined with Fentanyl in Postoperative Intravenous Analgesia

Objective To compare analgesic efficacy and safety of flurbiprofen axeyil combined with a small dose of fentanyl with fentanyl alone in postoperative intravenous analgesia for total hysterectomy patients.Methods 120 patients undergoing total hysterectomy in general anesthesia were randomly divided into four groups with thirty cases each.The dose assignment followed as:fentanyl 1 mg in group A,fentanyl 0.5 mg in group B,flurbiprofen axeyil 50 mg plus fentanyl 0.5 mg in group C,flurbiprofen axeyil 100 mg combined with fentanyl 0.375 mg in group D.The drugs in each group were diluted to 100 mL and infused by pumps.The visual analog scale(VAS),times of PCIA and incidence of side effects were recorded during the period of postoperative 24 hours.Results The VAS of group B at 2 h after operation was significantly higher than that of group A,C and D(P<0.05),which became similar 2 h later(P>0.05).The times required for supplemental bolus in group B was also more than that of A,C and D(P<0.05).The incidences of nausea,vomiting,itching and somnolence in group B,C and D were significantly less than those in group A(P<0.05).No respiratory depression or abnormal bleeding occurred in four groups.Conclusion Intravenous analgesia of flurbiprofen axeyil combined with a small dose of fentanyl had a better effect and safety than fentanyl alone and was able to reduce fentanyl requirement in total hysterectomy patients.