氟比洛芬复合芬太尼用于术后镇痛的疗效及安全性的研究

Clinical efficacy and safety of peri-operative analgesia with flurbiprofen and fentanyl

目的评价与芬太尼合用进行中等手术病人围术期镇痛的效果及安全性。方法192例病人随机分为4组,常规采用静吸复合麻醉,根据手术时间对术中芬太尼总量进行控制,术后采用静脉镇痛。氟比洛芬按照以下方案给予,除A组外,其余3组均于手术结束前给予氟比洛芬50mg。A组:术后芬太尼1mg+生理盐水100ml;B组:术后芬太尼1mg+生理盐水100ml;C组:术后100mg氟比洛芬+芬太尼0.5mg+生理盐水至100ml;D组;术后150mg氟比洛芬+芬太尼0.5mg+生理盐水至100ml。术后随访24h,记录生命体征、镇痛情况及其不良反应。结果整个研究共完成病例191例,4组手术病人一般情况无显著差别,术后24h内生命体征基本平稳。结果术后0h,VAS(视觉模拟疼痛评分)B,C,D<VASA,术后4,8h,VASC,D<VASA,术后24h,VASC<VASB。D组病人呕吐的发生率显著高于其它3组。结论氟比洛芬复合芬太尼用于中等手术病人围术期镇痛具有确切的疗效,不良反应发生率较低,可以安全用于临床。

Objective To assess the effect and safety of using flurbiprofen combined with fentanyl as peri-operative analgesia. Methods One hundred and ninety-two patients were randomly divided into four groups. Group A： fentanyl lmg ＋ 0.9% NaCl to 100ml, postoperatively. Group B： Flurbiprofen 50mg was injected before operation, fentanyl lmg ＋ 0.9% NaCl to 100ml, postoperatively. Group C： Flurbiprofen 50mg was injected before operation, flurbiprofen 100mg ＋ fentanyl 0.5mg ＋ 0.9% NaCl to 100ml, postoperatively. Group D： Flurbiprofen 50mg was injected before operation, flurbiprofen 150mg ＋ fentanyl 0.5mg ＋ 0.9% NaCl to 100ml, postoperatively. Pain scores at rest and adverse effects were recorded. Results No significant differences were found due to age, body mass index and surgery duration among the four groups. At 0h after the surgery, VAS （visual analog scale） B,C,D 〈 VASA; at 4, 8h after the surgery, VASC,D 〈 VASA; at 24h after the surgery, VASC 〈 VASB. The incidence of nausea in group D was higher than the other three groups. Conclusion In our study, peri-operative analgesia with flurbiprofen and fentanyl has a perfect analgesic effect and low adverse effects.