氟比洛芬酯超前镇痛用于阻塞性睡眠呼吸暂停综合征术后镇痛的可行性

Feasibility of preemptive analgesia of flurbiprofen axetil on post - OSAS patients pain relief

目的观察氟比洛芬酯用于阻塞性睡眠呼吸暂停综合征（OSAS）手术时超前镇痛作用效果，探讨对OSAS手术超前镇痛的可行性。方法50例ASAⅠ～Ⅱ级行OSAS手术的患者，随机分为Ⅰ组和Ⅱ组，每组25例。Ⅰ组手术开始前15min静脉缓注氟比洛芬酯100mg；Ⅱ组术前15min静脉缓注生理盐水20ml，分别记录术后1、2,4、6、8、12、24h的视觉模拟评分（VAS），24h曲马多、芬太尼用量和不良反应。并在镇痛结束后统计患者对镇痛治疗的总满意度。结果术后1、2、4、6hVAS评分：Ⅰ组均低于Ⅱ组（P〈0．05），术后24hⅠ组的曲马多用量（275±21）mg，芬太尼用量（275±21）μg，低于Ⅱ组的曲马多用量（298±23）mg，芬太尼用量（298±23）μg，镇痛结束后，患者对镇痛满意度Ⅰ组与Ⅱ组在Ⅱ级和Ⅳ级差异有统计学意义（P〈0．05）。结论氟比洛芬酯用于OSAS手术超前镇痛，能减少术后的曲马多、芬太尼用量，减轻不良反应的发生并能提高镇痛质量。

Objective To observe the preemptive analgesic effect of flurbiprofen axetil on post obstructive sleep apnea syndrome （OSAS） pain relief and studied its feasibilities. Methods Fifty patients （SAS Ⅰ- Ⅱ） were randomly assigned into two groups. The patients in group Ⅰ（ n = 25） received intravenous injection of flurbiprofen axetil 100 mg 15 min before surgery, and those in group Ⅱ（ n = 25 ） intravenous injection of saline 20 ml. Postoperative analgesia efficacy was assessed by visual analog scales （VAS） at 1,2,4,6,8,12 and 24 h after surgery. Tramadol and fentanyl requirements and adverse effects were recorded at 24 h after surgery. The overall satisfaction to analgesic therapy was evaluated. Results OSAS was lower in the group Ⅰat 1,2,4,6 h （ P 〈 0. 05） than that in group Ⅱ. Requirement s of tramadol Ⅰ（275 ± 21 ） mg, requirement of fentanyl （275 ±21 ） μg were significantly less in group Ⅱ which Tramadl （298 ±23）mg, and Fentanyl （298±23 ）μg. The overall satisfaction to analgesic therapy was significantly different between two groups in grade Hand Ⅳ （ P 〈 0.05 ）. Conclusion Flurbiprofen axetil can produce preemptive effect, save the requirements of tramadol and fentanyl, at the same time both reduce the adverse effect and increase quality of pain relief.