肛肠病术前应用氟比洛芬酯的麻醉效果观察

Observation on the Anesthetic Efficacy of Flurbiprofen Axetil Applied before Anorectal Surgical Operation

为观察氟比洛芬酯术前应用对肛肠病手术镇痛的作用效果，将60例ASAⅠ～Ⅱ级肛肠病手术患者随机分为A、B组，每组30例。A组术前15min静脉缓注氟比洛芬酯100mg（氟比洛芬酯加芬太尼PCIA），B组术前15min静脉缓注生理盐水20ml（芬太尼PCIA）。分别记录术后1，2，4，8h的视觉模拟评分（VAS）、24h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体满意情况。在手术结束时及术后24h各取外周血2ml检测PGEz浓度。结果显示，术后1，2，4，8h的视觉模拟评分（VAS）A组均低于B组（P〈0．05），术后24hA组的芬太尼用量（212．03±56．21）μg低于B组（289．65±100．32）μg（P〈0．05）。A组术后24h血清中PGE2浓度显著低于B组（P〈0．05）。结果表明，氟比洛芬酯于肛肠病术前应用能减少术后的芬太尼用量，提高镇痛质量，减轻炎症反应。

The 60 patients with ASA（ Ⅰ- Ⅱ stage） who were to undergo anorectal surgical operation were evenly divided into group A and B,30 in each group. 15 min before operation,patients in group A received slow venous injection of flurbiprofen axetil（100mg） plus fentanyl,while patients in group B received slow injection of normal saline plus fentanyl 15 min before operation. Visual analogue pain score（VAS） 1,2,4,8 hours after operation was recorded respectively,quantity and adverse reaction of fentanyl were also recorded within 24 hours,and the general satisfaction score on the anesthetic results from the patients were collected. The PGE2 concentration of peripheral blood taken immediately after the operation and at 24th hour after operation was also examined. As results, the VAS at postoperative 1,2,4,8 hours in group A was lower than that in group B（ P 〈0.05） ;the quantity of fentanyl examined within postoperative 24 hours in group A was lower than that in group B[（212.03±56.21）μg VS （289.65±100.32）μg, P 〈0.05）];and the PGE2 concentration in group A was lower than that in group 13（ P 〈0.05）. It is concluded that preoperative application of flurbiprofen axetil in the surgical treatment of anorectal diseases can reduce the postoperative quantity of fentanyl,raise the anesthetic efficacy and relieve inflammatory reaction.