预先用氟比洛芬酯于妇科术后镇痛的临床观察

Clinical observation of preemptive application Flurbiprofen axetil for postoperative analgesia undergoing gynecological surgery

目的观察比较术前预先应用氟比洛芬酯联合硬膜外吗啡、术后应用及单纯吗啡术后硬膜外镇痛在妇科手术术后的镇痛效果。方法将90例ASAⅠ~Ⅱ级的妇科手术患者随机分为3组,Ⅰ组术前10min注射氟比洛芬酯50 mg,手术结束时注入吗啡1.5 mg;Ⅱ组手术结束时注射氟比洛芬酯50 mg,吗啡1.5 mg;Ⅲ组手术结束时注入吗啡2mg.记录术中数据,用统计学方法分析处理。结果 VAS评分术后4h内Ⅱ组高于Ⅰ组,差异有统计学意义;不良反应发生率Ⅰ、Ⅱ组显著少于Ⅲ组,差异有统计学意义;镇痛效果Ⅲ组与Ⅰ、Ⅱ组相比差异有统计学意义。结论氟比洛芬酯联合硬膜外吗啡预先应用,镇痛效果更佳,可填补因硬膜外吗啡起效较慢导致的术后镇痛空白期。

Objective To observe and compare analgesic efficacy of preemptive analgesia with flurbiprofen axetil combined with epidural morphine,postoperative application and epidural morphine alone during gynecological operation.Metohds Randomly assigned ninety patients（ASAⅠ~Ⅱ） into three groups.Before surgery,the patients in group Ⅰ（n=30）received intravenous flurbipmfen axetil 50 mg in 10 minutes,and after surgery epidural morplline 1.5 mg.Patients in group Ⅱ（n=30）received both intravenous flurbiprofen axefil 50 mg and epidural morphine 1.5mg after surgery,and those in group Ⅲ only received epidural morphine 2mg after surgery.The data were recorded and analysed by statistics methods.Results All of the patients in three groups had got the satisfactory efficacy of postoperative analgesia.During the first 4 hours,the VAS of group II was higher than that of group I significantly.The percentage of patients who had vomiting,nausea and pruritus was lower in group I and group II than that in group Ⅲ.Conclusion On the basis of these materials,flurbiprofen axetil combined with epidural morphine has the better analgesic efficancy.Flurbiprofen axetil combined with epidural morphine will improve the analgesic effects and obviously overcome the shortage of slow effect with epidural morphine.