氟比洛芬酯用于腹腔镜术后镇痛临床药效学研究

目的：用序贯法测定氟比洛芬酯（FA）用于腹腔镜术后镇痛时不同给药方法的半数有效剂量（ED50）。方法：选取80例择期腹腔镜手术治疗患者,随机分为4组,各20例。氟比洛芬酯（A）组：停用瑞芬前5min,静滴FA;超前镇痛（B）组：诱导前5min静滴FA50mg,停用瑞芬前5min再静滴FA;复合（C）组：停用瑞芬前5min静滴芬太尼2μg/kg和FA;混合（D）组：诱导前5min静滴FA50mg,停用瑞芬前5min静滴芬太尼2μg/kg和FA。采用序贯试验法,梯度为0.2mg/kg。计算各组ED50及95%置信区间（CI）。结果：FA的ED50：A组为1.44mg/kg,B组为0.79mg/kg,C组为0.58mg/kg,D组为0.42mg/kg。95%CIA～D组分别为1.34～1.56mg/kg、0.64～0.98mg/kg、0.44～0.76mg/kg和0.36～0.49mg/kg。结论：超前镇痛、复合芬太尼的平衡镇痛,可降低FA的ED50。

Research on clinical pharmacodynamics of flurbiprofen axetil for postoperative analgesia in patients undergoing laparoscopic operation

Objective：To determine the median effective dose（EDs0）of flurbiprofen axetil（FA）for postoperative analgesia in patients undergoing laparoscopic operation with up-and-down sequential experiment.Methods： Eighty patients,undergoing selective laparoscopic operation were randomly divided into 4 equal groups.FA group（group A）：FA was administered 5 minutes before stopping remifentanyl.Preemptive analgesia group（group B）：FA 50mg was administered both 5 minutes before intubation and 5 minutes before stopping remifentanyl. Combination group（group C）：fentanyl 2μg/kg and FA were used 5 minutes before remifentynl is discontinued. Combination group （group D）：flurbiprofen 50rag was administered 5 minutes before intubation,fentanyl 2μg/kg and FA were used 5 minutes before stopping remifentynl.Based on the 30th minutes＇ VSA postoperatively,up- and-down sequential experiment was used in. ED50 of FA was calculated according to Dixon and Massey. Results：Flurbiprofen＇s ED50 in Group A-D was 1.44mg/kg,0.79mg/kg,0.58mg/kg and 0.42mg/kg,respectively. And 95% CI in Group A-D was 1.34-1.56mg/kg,0.64-0.98mg/kg,0.44-0.76mg/kg and 0.36-0.49mg/kg,respectively.Conehision：Both preemptive using and combining with fentanyl can decrease FA＇s ED50.