氟比洛芬酯复合吗啡在消化道肿瘤术后镇痛的效果观察

The postoperative analgesic effects of flurbiprofen axetil and morphine on patients undergoing the digestive tract tumor surgery

目的:评价氟比洛芬酯复合吗啡在消化道肿瘤术后镇痛的临床效果。方法:60例择期行消化道肿瘤手术的患者,随机分为3组(n=20):对照组(A组),术前氟比洛芬酯组(B组),术后氟比洛芬酯组(C组)。A组术毕静脉注射吗啡0.03mg/kg,B组术前静注氟比洛芬酯50mg,术后12、24、36h各静注氟比洛芬酯50mg,C组术后12、24、36h各静注氟比洛芬酯50mg。3组患者术后应用吗啡PCA镇痛,其参数为:PCA剂量2ml,背景计量0,锁定时间为15min。记录术后6、12、24、36、48h的VAS评分,48h的PCA次数及所剩药液量,不良反应记录恶心、呕吐、嗜睡、尿潴留、呼吸抑制等。结果:术后6、12、24hA组的VAS评分高于B、C组(P<0.05),术后6、12、24hC组的VAS评分高于B组(P<0.05);术后48hA组的剩余液显著少于B、C组(P<0.05),按压次数显著多于B、C组(P<0.05)。B、C组不良反应发生率低于A组(P<0.05),B、C组间无显著性差异。结论:使用氟比洛芬酯复合吗啡镇痛于消化道肿瘤术后镇痛在减少吗啡用量的情况下能达到良好的镇痛目的,而且有超前镇痛作用。

Objective：To evaluate the analgesic efficacy and complications of intravenous postoperative analgesia with flurbiprofen axetil injection combined with morphine and with morphine alone on patients undergoing the digestive tract tumor surgery.Methods：Sixty ASAI^II postoperative patients aged 30-75years weighing 45 -70 kg undergoing the digestive tract tumor surgery were randomly assigned to three groups ：group A received PCIA which was commenced with a loading dose of morphine 0.03 mg/kg;group B received intravenous flurbiprofen axetil injection 50 mg 10 min before surgery and 12,24,36 h after surgery;group C received flurbiprofen axetil injection 50 mg 12,24,36 h after surgery .Three groups received PCIA with 0.05% morphine＋granisetron 0.003%.The PCA pump was set up with an 2 ml bolus with a 15 min lockout interval and no background infusion.The visual analogue score （VAS）, times of PCA and incidence of side effects were recorded during the period of postoperative 48 hours.Results：The VAS of group A was significantly higher than that of group B and C at 6,12,24 h after surgery （P〈0.05）.The VAS of group C was higher than that of group B at 6,12,24 h after surgery. The pressing times of group A were remarkably more than that of group B and C at 48 h after surgery.The incidences of nausea, vomiting, somnolence in group B and C were significantly less than those in group A （P〈0.05）.Conclusion：Flurbiprofen axetil injection can produce preemptive analgesia effect. Intravenous postoperative analgesia with flurbiprofen axetil injection combined with morphine has a better effect than morphine alone and can reduce its side effects.