氟比洛芬酯复合芬太尼用于肝功能不全患者的术后镇痛

Postoprative analgesia with flurbiprofen axetil and fentanyl in patients with abnormal liver function

目的评价氟比洛芬酯(FA)复合芬太尼用于肝功能不全术后患者自控静脉镇痛(PCIA)的效果及不良反应。方法90例肝炎肝硬化门脉手术患者,静脉全麻术后随机均分为三组。PCIA镇痛用药:A组,芬太尼1mg;B组,FA200mg加芬太尼0.5mg;C组,FA250mg加芬太尼0.5mg。均加生理盐水至100ml。PCA方案:背景剂量2ml/h,自控单次入量2ml,锁定时间15min。记录术后6、12、24和48h的VAS评分及其不良反应。结果术后12、24和48hB、C两组VAS评分明显小于A组(P<0.05)。三组肝功能指标术前术后差异无统计学意义。C组患者呕吐发生率高于A、B两组(P<0.05)。结论FA复合芬太尼用于肝功能不全患者术后PCIA镇痛效果好,不良反应发生率较低。

Objective To assess the effect and safety of flurbiprofen axetil（FA） with fentanyl used for patient-controlled intravenous analgesia（PCIA） in patients with abnormal liver function. Methods Ninety patients underwent portal hypertension surgery under intravenous anesthesia were randomly allocated to three groups with 30 cases each. The analgesic drug was fentanyl 1 mg in group A, FA 200 mg plus fentanyl 0. 5 mg in group B and FA 250 mg plus fentanyl 0. 5 mg in group C, which were all diluted with 0.9G NaCI 100 ml. PCIA was set at 2 ml/h with bolus close of 2 ml and locked time of 15 rain. VAS and side effects were recorded at 6,12,24,and 48 h during analgesia. Results VAS scores were significantly lower in group B and C than those in group A at 12,24,48 h after the surgery （P〈0. 05）. The incidence of nausea in group C was higher than that in groups of B and A （P〈0.05）. There were no significant changes of liver function during analgesia in three groups. Conclusion PCIA with FA and fentanyl has a perfect analgestic effect and low adverse effects in the patients with abnormal liver function.