曲马多和氟比洛芬酯用于经皮肾穿刺取石术超前镇痛的效果

Effects of preemptive analgesic management on Tramadol and flurbiprofen axetil in the preemptive analgesia after percutaneous nephrolithotomy

目的比较曲马多与氟比洛芬酯超前镇痛对经皮肾穿刺取石术(PCNL)后镇痛的效果及安全性。方法 60例择期行PCNL成年患者随机分成曲马多组(T组)、氟比洛芬酯组(K组)、生理盐水组(N组),每组20例。手术开始前10min,T组静注曲马多2mg/kg,K组静注氟比洛芬酯1mg/kg,N组静注生理盐水10ml,于术后2h、12h、24h监测患者血压、心率和呼吸频率的变化,采用VAS视觉模拟评分法对患者的疼痛程度进行评价。结果 T组与K组各观察时点的VAS评分均低于N组(P<0.05),但两组间的VAS评分差异无统计学意义。三组患者血压、心率、呼吸频率变化差异无统计学意义,均无呼吸抑制及过敏反应。结论 PCNL患者,曲马多和氟比洛芬酯用于超前镇痛,能有效术后镇痛,无明显不良反应。

Objective To compare the effects of tramadol and flurbiprofen axetil on preemptive analgesia after percutaneous nephrolithotomy（PCNL）.Methods Sixty ASAⅠ~Ⅱ adult patients undergoing percutaneous nephrolithotomy were randomly assigned into three groups,which received either a bolus of 2 mg/kg tramadol（Group T,20 cases） or 1 mg/kg flurbiprofen axetil（Group K,20 cases） or 10 ml normal saline（Group N,20 cases） 10 minutes before the surgery.The heart rate,blood pressure,breathing rate and adverse drug reactions were evaluated at 2 h,4 h,8 h,12 h,24 h after the surgery.The visual analogue scale（VAS） was used to evaluate the pain of the patients.Results A significant decrease of the VAS scores were found in Group T and Group K in comparison with Group N（P0.05）,but no statistically significant difference were found between Group T and Group K.The heart rate,blood pressure,breathing rate showed no significant differences in patients of the three groups,all with no respiratory depression and allergic reactions.Conclusion Applying of tramadol and flurbiprofen axetil before the operation provides a better postoperative analgesia for the patients undergoing PCNL.