联合氟比洛芬酯和曲马多用于妇科术后静脉自控镇痛的临床研究

The Clinical Research that Flurbiprofen axetil and Tramadol Treatment Intravenous Controlled Analgesia After Gynecologic Surgery

目的:研究联合氟比洛芬酯和曲马多用于妇科术后患者静脉自控镇痛的疗效。方法:60例ASA Ⅰ～Ⅱ级择期行妇科手术的患者,均采用连续硬膜外麻醉。术后PCIA镇痛,随机分为3组(n=20):Ⅰ组,曲马多1300mg+生理盐水共200ml;Ⅱ组:氟比洛芬酯100mg+曲马多1300mg+生理盐水共200ml;Ⅲ组:氟比洛芬酯100mg+曲马多700mg+生理盐水共200ml。PCIA参数设定:负荷量5m1,持续输注量5ml/h,PCA量2ml,锁定时间15min。观察术后24小时内(2h、4h、8h、20h、24h)的镇痛评分(VAS)、PCA使用次数及不良反应发生情况。结果:三组患者的年龄、体重、手术时间、术中出血量、术中芬太尼用量均无显著性差异。术后2h、4hⅠ组的VAS评分显著高于Ⅱ、Ⅲ组(P<0.05),术后8、20、24h是的VAS评分三组间无显著差异(P>0.05);24小时内PCA按压次数Ⅰ组明显多于Ⅱ、Ⅲ组(P<0.05),恶心、呕吐的发生率Ⅲ组明显低于Ⅱ组、Ⅰ组(P<0.05),嗜睡和头晕的发生率。Ⅲ组低于Ⅱ组、Ⅰ组(P<0.05)。三组镇痛时间均无呼吸抑制。结论:Ⅲ组明显低于Ⅱ组、Ⅰ组,不如用曲马多用妇科术后静脉自控镇痛的效果良好,不良反应的发生率低。

Objective：The Clinical Research that Flurbiprofen axetil and Tramadol Treatment Intravenous Controlled Analgesia After Gynecologic Surgery.Methods：60 cases thant Choose the date line gynecological surgery patients PCIA postoperative analgesia of ASA Ⅰ -Ⅱ divided into 3 groups Randomly（n=20）.The first group treatment with tramadol（1300mg） and Saline 200ml altogether;The second group treatment with flurbiprofen axetil（100mg） and tramadol（1300mg） and Saline 200ml altogether;The third group treatment with flurbiprofen axetil（100mg） and tramadol（700mg） and Saline 200ml altogether.Parameter setting of PCIA： Load 5ml,Continuous infusion 5ml/h, PCA 2ml,Locking time 15min. Observe within 24 hours（2h,4h,Sh,20h,24h） after the operation of VAS, used times frequency and adverse reaction conditions.Results：Three groups of the patient＇s age, weight, operation time, peri-operative bleeding, dosage of fentanyl were no significant 2h, Ⅰ4h VAS score significantly higher than the group Ⅰ, Ⅰgroup （P〈0.05）,8,20,scoring three VAS 24h yes no significant differences between groups （P〉0.05）.24 hours Ⅰfrequency press PCA group than Ⅱ, Ⅲ group （P〈0.05）, and the incidence of nausea and vomiting Ⅲ group Ⅰobviously lower than Ⅰgroup, the group（P〈0.05）,sleepiness and the incidence of dizziness.Ⅲgroup Ⅱ below Ⅰ group,the group （P〈0.05）. Three groups of time without respiratory inhibition analgesia.Conclusions：Ⅲ group Ⅱ obviously lower than Ⅰ group, with song,multi-purpose gynecological surgery horse of intravenous controlled analgesia effect is good, the incidence of aderse cents.