氟比洛芬酯与曲马多用于妇科宫腔镜手术超前镇痛的效应比较

Preemptive analgesia with flurbiprofen axetil or tramadol before gynecologic hysteroscopic surgery:a comparison of outcome

目的比较宫腔镜术前分别应用氟比洛芬酯与曲马多超前镇痛的效应。方法将60例择期行妇科宫腔镜手术的患者随机分为两组,每组30例。分别于麻醉诱导前5min静脉注射氟比洛芬酯100mg(氟比洛芬酯组)或曲马多100mg(曲马多组)进行超前镇痛。所有患者均以瑞芬太尼、丙泊酚诱导,喉罩通气,行全凭静脉麻醉。观察术后苏醒时间,术后0.5h、1h、2h、6h、12h的疼痛视觉模拟(VAS)评分、术后并发症发生率。结果两组在术后0.5h的VAS评分最高,1h后逐渐下降,2h、6h、12h的VAS评分低于0.5h(P<0.05);各时点的VAS评分组间比较,差异均无统计学差异。两组患者术后苏醒时间的差异无统计学意义(P>0.05);曲马多组恶心、呕吐发生率为30.0%,高于氟比洛芬酯组的10.0%(P<0.05);曲马多组术后咽喉疼痛的发生率为20.0%,高于氟比洛芬酯组的6.7%(P<0.05)。结论氟比洛芬酯具有与曲马多相同的超前镇痛效应,而术后恶心、呕吐及咽喉疼痛的发生率较低。

Objective To compare the effect of preemptive analgesia with flurbiprofen axetil or tramadol before operation.Methods Sixty patients undergoing gynecological hysteroscopic surgery were randomly divided into two groups,including tramadol group and flurbiprofen group with 30 cases in each group.Two groups of patients were all induced with remifentanil and propofol,intubated with laryngeal mask and implemented by a program of total intravenous anesthesia.Five minutes before anesthesia,two groups were injected with flurbiprofen axetil 100 mg or tramadol 100 mg,respectively.Time of postoperation recovery,visual analog seale（VAS）at each time point and adverse events were recorded.Results VAS was Maximum at 0.5 h after operation,descended gradually 1 h after operation.VAS at 2 h,6 h,12 h after operation were significantly lower than that at 0.5 h after operation（P0.05）.VAS between two groups had no statistically difference at each time point.Time of postoperation recovery between two groups had no statistical difference（P0.05）.The incidence of postoperative nausea and vomitting（PONV）in tramadol group was significantly higher than that in flurbiprofen group（30.0% vs 10.0%,P0.05）,the incidence of sore throat in tramadol group was significantly higher than that in flurbiprofen group（20.0% vs 6.7%,P0.05）.Conclusion Compared with tramadol,preemptive analgesia with flurbiprofen was effective equally,and had lower incidence of PONV and sore throat.