氟比洛芬酯复合芬太尼用于内镜下甲状腺切除术术后镇痛的效果观察

Post-operative analgesia with flurbiprofen and fentanyl treatment after endoscopic thyroidectomy

目的观察氟比洛芬酯复合芬太尼用于鼻内窥镜手术后静脉自控镇痛（PCIA）的有效性和不良反应。方法择期内镜下甲状腺切除术患者60例，手术结束后随机分为两组：实验组：术毕静脉注射氟比洛芬酯50mg为负荷剂量后接PCA泵，泵内药物为氟比洛芬酯200mg＋芬太尼0．5mg＋生理盐水至100ml；对照组：术毕静脉注射芬太尼0．05mg为负荷剂量后接PCA泵，泵内药物为芬太尼1．2mg＋生理盐水至100ml。两组均采用持续输注2．0ml／h，单项PCA剂量0．5ml，锁定时间15min。记录术后48h内镇痛评分（VAS）、镇静评分（SS）及不良反应。结果两组镇痛效果、镇静评分差异无统计学意义（P〉0．05），实验组恶心、呕吐和头晕等不良反应低于对照组（P〈0．05）。结论氟比洛芬酯复合芬太尼用于内镜下甲状腺切除术后静脉自控镇痛，可减少芬太尼不良反应，提高镇痛质量。

Objective To observe the effect and side-effect of post operative PCIA with flurbiprofen and fentanyl treatment after endoscopic thyroidectomy. Methods 60 cases of such patients were divided into two groups： In treatment group（flurbiprofen 200mg＋fentany10. 5mg）, the loading dose was flurbiprofen 50 mg prior to the PCA： In control group（fentanyl 1.2 mg）, the loading dose was fentanyl 0.05 mg prior to the PCA. The PCA 0.5ml with 15 min interval, lhe VAS and SS scores were evaluated in 48 hours after treatment. Results There was no significant difference in VAS and SS scores between two groups（P〉 0.05）. The sideeffects were lower in treatment group than it in control group（P〈 0.05）. Conclusion Coadministration of flurbiprofen with fentanyl by PCIA after endoscopic thyroidectomy offers overall favorable analgesic responses.