氟比洛芬酯-亚甲蓝术后长效镇痛的临床观察

Clinical efficacy of flurbiprofen axetil and methylthioninium chloride combination for long-term postoperative analgesia

目的:观察氟比洛芬酯与亚甲蓝联合应用于痔瘘术后长效镇痛的有效性和安全性。方法:择期痔瘘手术患者40例,采用数字随机表法随机分成两组,每组20例。FM组:术前15 min氟比洛芬酯2 mg/kg静脉缓慢推注,术毕用0.1%亚甲蓝10 ml作局部浸润性注射于创面。M组:仅术毕用0.1%亚甲蓝10 ml作局部浸润性注射于创面。观察记录2、4、6、8、12 h镇痛评分(VAS)、不良反应(包括伤口烧灼感、尿潴留、嗜睡、恶心、呕吐)发生情况及进行疗效评价。结果:术后4、6 h VAS评分FM组显著低于M组(P<0.05),止痛效果FM组优于M组。FM组的显效率与M组比较,差异无统计学意义(P>0.05),FM组伤口烧灼感的不良反应明显少于M组(P<0.05)。结论:氟比洛芬酯与亚甲蓝联合应用于痔瘘术后镇痛效果良好,可持续长效镇痛,不良反应少,是一经济适用简便的术后多模式镇痛方法。

Objective：To observe the efficacy and safety of combined flurbiprofen axetil with methylthioninium chloride for long-term analgesia after operation of hemorrhoids and fistulas.Methods：Forty patients undergone selective operation of hemorrhoids and fistulas were randomized into 2 groups（n=20 for each）.FM group received intravenous bolus injection of flurbiprofen axetil in a dose of 2 mg/kg 15 min before the procedure and postoperative topical infiltration of 0.1% methylthioninium chloride injection by 10 ml around the wound,and M group were managed with local infiltration anesthesia of 10 ml 0.1% methylthioninium chloride after operation.The two groups were also observed concerning postoperative VAS scoring at 2,4,6,8 and 12 h,respectively,and adverse reactions,including wound burning sensation,incidences of urinary retention,drowsiness,nausea and vomiting for therapeutic assessments.Results：VAS scores after 4h and 6h and adverse reactions as well as analgesic effect in FM group were significantly lower and better as compared with M group（P0.05）,yet,the excellence rates regarding analgesic effect between the two groups showed no difference（P0.05）except for fewer wound burning sensation found in FM group（P0.05）.Conclusion：Flurbiprofen axetil and methylthioninium chloride combination can produce long-term analgesic effects on patients after operation of hemorrhoids and fistula as well as less adverse effects,and be simple in performance and cost saving.