氟比洛芬酯复合曲马多用于开胸患者全麻苏醒期镇痛效果研究

Analgesic Effect of Flurbiprofen Axetil with Tramadol on Patients during Recovery from General Anesthesia in Thoracotomy

目的探讨氟比洛芬酯复合曲马多用于开胸患者全麻苏醒期的镇痛效果与安全性。方法选择30例ASAⅠ-Ⅲ级在静吸复合全麻下行开胸手术患者,随机分为3组:曲马多组(Ⅰ组)、氟比洛芬酯组(Ⅱ组)、曲马多复合氟比洛芬酯组(Ⅲ组),每组10例。3组分别于术毕前30 min静注给药。手术结束后送恢复室,比较3组患者睁眼时间、拔管时间、手术时间、拔管即刻疼痛评分(VRS评分)、不良反应发生情况及术前术后血压(BP)、心率(HR)的变化。结果Ⅲ组VRS评分显著低于Ⅰ、Ⅱ组(均P<0.01)。Ⅰ、Ⅲ组睁眼时间、拔管时间较Ⅱ组延长,差异均有统计学意义(均P<0.05);3组手术时间相比,差异均无统计学意义(均P>0.05)。Ⅰ、Ⅱ组患者拔管即刻、拔管后5 min BP、HR明显升高,与基础水平相比,差异均有统计学意义(均P<0.05);而Ⅲ组患者BP、HR仅轻度升高,与基础水平相比,差异均无统计学意义(均P>0.05);3组均无明显呼吸抑制。结论复合应用氟比洛芬酯与曲马多不但全麻苏醒期镇痛效果好,且不增加不良反应的发生。

Objective To study the analgesic effect and safety of flurbiprofen axetil with tramadol on general anaesthesia in thoracotomy. Methods A total number of thirty ASA Ⅰ-- Ⅲ adult patients who undergone thoracotomy were divided into three groups randomly. Group Ⅰ（n=10） received tramadol;Group [Ⅱ（n=10） received flurbiprofen axetil;Group Ⅲ （n=10） received flurbiprofen axetil with tramadol. Different medicine was given to different groups at 30 min to operation completion. The rate of restlessness and cough during recovery, the time of opening eyes when called,the time of extubation,the time of operation, VRS score of extubation, adverse drug reaction and the change blood pressure（BP）and heart rate（HR）at before and after the operations. Results The VRS score n group Ⅲ was significantly lower than group Ⅰ and Ⅱ （all P〈 0.01）. The time of opening eyes and extubation in group Ⅱ and Ⅲ were longer than group Ⅱ ,there were significant diference（all P〈0.05）. There was no significant diference between the time of operation in three groups（all P〉0.05）. Extubation immediately, 5 minuters after extubation BP,HR in group Ⅰ and Ⅱ increased significantly,there were significant difference than basal（all P〈0.05） ;BP,HR in group Ⅲ mildly elevated,there was no significant than basal（all P〉0.05）.All groups had no significant respiratory depression. Conclusion Flurbiprofen axetil with tramadol made good analgesic effect on patients during recovery of general anaesthesia in thoracotomy without adverse effects.