不同超前镇痛时点应用氟比洛芬酯对小儿术后镇痛效果的影响

Effect of pre-emptive analgesia with Flurbiprofen Axetil on different time for post-operative pain in child

目的观察不同超前镇痛时点应用氟比洛芬酯对小儿术后镇痛效果的影响。方法择期静脉全麻下行疝囊高位结扎术患儿60例,随机分为A、B两组,每组30例。A组患儿于手术结束时和术后12 h静脉注射氟比洛芬酯12 mg/kg加生理盐水至100 mL,B组患儿分别于术前15 min和术后12 h静脉给予氟比洛芬酯12 mg/kg加生理盐水至100 mL,负荷剂量均为氟比洛芬酯0.5 mg/kg,术后静脉自控镇痛(patient controlled intravenous analgesia,PCIA)泵设置持续量为2 mL/h,单次给药量为0.5 mL,间隔时间为20 min。监测并记录两组患儿术后1、2、4、8、12、24 h的生命体征变化、镇痛和镇静效果及不良反应发生情况。结果 A组在术后1、2、4、8、12 h的疼痛评分高于B组(P<0.05)。A组在术后患者自控镇痛(patient-controlledanalgesia,PCA)给药次数高于B组(P<0.05)。A、B两组恶心、呕吐发生率差异无统计学意义(P>0.05)。两组各时点镇静评分差异无统计学意义(P>0.05)。结论氟比洛芬酯超前镇痛较术后应用更能有效减轻疝囊高位结扎术患儿术后疼痛,且无明显不良反应,用于小儿术后镇痛安全有效。

Objective To observe the effect of pre-emptive analgesia with Flurbiprofen Axetil on different time for post-op- erative pain in child. Methods 60 cases of children with hernial sac high ligation by elective vein anesthesia, who were di- vided into A and B groups, 30 cases in each group. A group were treated with Flurbiprofen Axetil 12 mg/kg added normal saline to 100 mL at the end of the surgery and postoperative 12 h, B group were treated with Flurbiprofen Axetil 12 mg/kg added normal saline to 100 mL before the operation 15 min and postoperative 12 h. The loading dose of two groups were Flurbiprofen Axetil 0.5 mg/kg, PCA pump set for continuos content was 2 mL/h, a single dose of 0.5 mL, interval time was 20 min. Monitored and record vital signs change, analgesia and composed effect, adverse reaction of three groups in post- operation 1, 2, 4, 8, 12, 24 h. Results The pain grade of A group were higher than B group at 1, 2, 4, 8, 12 h （P 〈 0.05）. PCA time administer drug was higher than B group （P 〈 0.05）. Incidence of nausea and vomiting of A and B group, the dif- ference wasn＇t statistically significant （P 〉 0.05）, compared the sedation score of three groups, there was no statistically sig nificant difference （P 〉 0.05）. Conclusion Pre-emptive analgesia with Flurbiprofen Axetil can reduce postoperative pain of chil dren with hernial sac high ligation, adverse reaction is little, and it is safe and effective for children postoperative analgesia.