氟比洛芬酯对颅内动脉瘤血管内治疗术后头痛的镇痛作用

The postoperative analgesic activity of flurbiprofen to intracranial aneurysm patients who went under endovascular treatment

目的观察氟比洛芬酯对普鲁泊福、瑞芬太尼维持麻醉的颅内动脉瘤血管内治疗术后头痛的镇痛作用。方法将40例ASA分级Ⅰ～Ⅱ级需接受血管内治疗的颅内动脉瘤患者按照信封抽取法随机分为氟比洛芬酯组和对照组，每组20例。氟比洛芬酯组在穿刺前10min及手术结束时分别给予氟比洛芬酯1mg／kg；对照组在相应的时间给予相应剂量的脂肪乳剂。观察两组患者在术前与术后循环的变化情况，术后头痛视觉模拟评分（VAS）及身体舒适度评分（BCS）。结果对照组在术后1、2、3h平均动脉压（MAP）较术前明显升高（P〈0．05），心率无明显变化（P〉0．05）；氟比洛芬酯组在术后1、2、3h MAP和心率与术前比较差异均无统计学意义（P〉0．05）。氟比洛芬酯组术后1、2、3h的头痛VAS[分别为（0．30±0．65）、（0．30±0．57）、（0．25±0．44）分]均明显低于对照组[分别为（3．25±1．58）、（3．00±1．56）、（2．90±1．48）分]（P〈0．05），BCS[分别为（3．30±0．86）、（3．45±0．86）、（3．62±0．86）分]明显高于对照组[分别为（1．20±1．00）、（1．45±0．94）、（1．50±1．00）分]（P〈0．05）。结论氟比洛芬酯可减轻颅内动脉瘤血管内治疗术后的头痛。

Objective To investigate the postoperative analgesic activity of flurbiprofen to intracranial aneurysm patients who went under endovascular treatment with propofol and remifentanil anesthesia. Methods Totally 40 ASA physical status Ⅰ - Ⅱ intracranial aneurysm patients were randomly scheduled flurbiprofcn group （group F,20 cases） and control group （group C,20 cases）. The patients in group F were given flurbiprofen 1 mg/kg respectively at 10 min before operation and at the end of the operation; while the patients in group C were given fat milk at the same time. The patients＇ circulation of the two groups before and after operation, the headache visual analog scores （VAS） and body comfort score （BCS） were observed. Results The mean arterial pressure（MAP） in group C after operation 1, 2 and 3 h were significantly higher than that before operation （P 〈 0.05 ） ; the heart rate in group C after operation had no significantly difference compared with before operation （P 〉 0.05）. The MAP and the heart rate in group F had no significantly differences before and after operation（P 〉 0.05 ）. The VAS of postoperation headache after operation 1,2 and 3 h were （0.30 ± 0.65 ）, （0.30 ± 0.57） and （0.25 ± 0.44） scores in group F,whieh were significantly lower than those in group C [ （3.25 ± 1.58 ）, （3.00 ± 1.56 ） and （2.90 ± 1.48 ） scores ] （P 〈 0.05 ） ; the BCS after operation in group F after operation 1 ,2 and 3 h were （3.30 ±0.86）, （3.45 ±0.86） and （3.62 ±0.86） scores,which were significantly higher than those in group C [ （1.20 ± 1.00）, （1.45 ± 0.94） and （1.50 ± 1.00 ）scores ] （P 〈 0.05 ）. Conclusion Flurbiprofen can reduce intracranial aneurysm patient＇s postoperative headache under endovascular treatment.