氟比洛芬酯联合吗啡用于术后镇痛的疗效观察

Morphine-sparing effect of flurbiprofen axetil for postoperative patient controlled analgesia

目的探讨氟比洛芬酯用于术后病人自控静脉吗啡镇痛的节俭作用。方法随机选择ASAI～II级择期行妇科恶性肿瘤根治手术的病人30例,随机分成三组,术后均采用病人自控静脉吗啡镇痛。M组:术毕缝皮时开启镇痛泵。F1组:手术结束前约30分钟静注氟比洛芬酯50mg,术毕开启镇痛泵。F2组:手术结束前约30分钟、术后8小时各静注氟比洛芬酯50mg,术毕开启镇痛泵。镇痛药液配制如下:吗啡0.3mg/ml,背景输注速度1ml/h,患者自控量(PCA)2ml,锁定时间5min。术后4小时、24小时、48小时随访,采用视觉模拟评分法(VAS)评估镇痛效果,并记录镇痛药物用量和不良反应。结果三组4hVAS评分有差异(p<0.05),24h和48hVAS评分无显著性差异(P>0.05)。24h和48h吗啡总量、PCA按压次数和有效次数M组较F1及F2组多,有显著性差异(P<0.01)。恶心、呕吐、瘙痒的发生以M组为多,F1及F2组较少。头晕的发生两组相似,无明显差异。结论氟比洛芬酯用于术后病人自控静脉镇痛,能够节俭吗啡的用量,减少吗啡的副作用,提高术后镇痛质量。

Objective To investigate the morphine-sparing effect of intravenous flurbiprofen axetil for postoperative patient-controlled analgesia. Methods 30 patients（ASA Ⅰ-Ⅱ） undergoing malignancy total correction procedure in gynecology were randomly divided into three groups： morphine alone 0.3 mg/ml-~ at the end of the procedure（Group M）, adding flurbiprofen axetil 50mg at the end of the procedure （Group F1）and at the 8 hours after operation（Group F2） respectively.VAS were used to evaluate the analgesic response. Resu/ts Patients in the three analgesic groups did not show significant differences in the VAS values（P〉0. 05）. Total morphine consumption, PCA pressing times and effective times in group M were significantly more than those in group FI and group F2（P〈O. 05）. The incidence of nausea and vomiting was highest in group M and the incidence of pruritus was the same in all tile group. Conclusion The dual add-on postoperative intravenous administration of flurbiprofen axetil to the morphine regimen can spare morphine consumption and dcrease side effects.