氟比洛芬在肝癌射频消融术麻醉中的应用

Application of Flurbiprofen Axetil Injection in Total Intravenous Anesthesia for Radiofrequency Ablation

【目的】探讨肝癌射频术中应用氟比洛芬是否可以减少静脉麻醉导致的呼吸抑制的发生。【方法】选择射频治疗肝癌患者60例,随机分为K组和N组,每组各30例,其中K组术前15min静脉注射氟比洛芬50mg,N组术前15min静脉注射生理盐水5mL,两组均以异丙酚复合瑞芬太尼微量泵维持麻醉。使记录术前、手术开始时、手术开始后5min及患者术后苏醒时的平均动脉压、心率、脉搏氧饱和度及呼吸频率,监测动脉血二氧化碳分压;记录患者苏醒时间;记录出现术中体动、呼吸暂停的例数。【结果】瑞芬太尼用量K组[(0.22±0.03)mg]显著少于N组[(0.51±0.07)mg,P<0.01]。术中体动K组(2例)少于N组(7例),呼吸暂停N组(12例)显著大于K组(2例)。【结论】氟比洛芬可以减少肝癌射频术中瑞芬太尼的用量,降低呼吸抑制等副作用的发生率。

[Objective] Percutaneous radiofrequency ablation （PRFA） is a new and effective mini-invasive surgery for small hepatocellular carcinoma. This study was to observe if flurbiprofen axetil injection used in PRFA can reduce the reaction of respiratory depression. [ Methods ] Sixty patients scheduled for PRFA were divided randomly into two groups： Group K and Group N. Those in Group K received flurbiprofen axetil injection at the dose of 50 mg 15 min before PRFA, and the patients in group N were given normal saline （NS） 5 mL at the same time. The two groups were given continuously intravenous infusion of remifentanil combined with propofol by micro pump. The mean arterial pressure （MAP）, heart rate （HR）, pulse oxygen saturation （SPO2）, respiratory rate （RR）, and partial pressure of carbon dioxide in artery （PaCO2） and recovery time were recorded. The lower limb movement, apnea, and body movements were recorded during operation. [Results]The total consumption of remifentanil in group K [（0.22±0.03） mg] was less than that in group N [（0.51 ±0.07） mg] （/9 〈 0.01）. Patients had less lower limb movement and less respiratory depression reaction in group K than that in group N. [Conclusions] Flurbiprofen axetil injection can reduce the consumption of remifentanil and reduce the reaction of respiratory depression in anthesia for PRFA.