氟比洛芬酯与曲马多用于子宫动脉栓塞下刮宫术后镇痛效果的观察

The effect of postoperative analgesia of flurbiprofen axetil and tramadol for patients with artificial abortion after the uterine artery embolism for cesarean scar pregnancy

目的观察氟比洛芬酯和曲马多用于因子宫瘢痕妊娠行子宫动脉栓塞下刮宫术后患者静脉自控镇痛的效果。方法子宫瘢痕妊娠患者54例,拟行子宫动脉栓塞下刮宫术,随机均分为三组:F组(氟比洛芬酯),负荷量1mg/kg,按压剂量5mg,输注剂量7.5mg/h;T组(曲马多),负荷量1mg/kg,按压剂量10mg,输注剂量15mg/h;C组(生理盐水),负荷量5ml,按压剂量2ml,输注剂量3ml/h;记录刮宫术前和苏醒后1、4、8、12、24h的HR、MAP、VAS评分、24h内按压次数和恶心呕吐。结果各时点HR、MAP、VAS评分和按压次数F组和T组比较差异无统计学意义,但与C组比较,F、T组HR减慢,MAP降低(P<0.05),按压次数和VAS评分均显著降低(P<0.01)。三组间恶心呕吐发生率差异无统计学意义。结论氟比洛芬酯与曲马多用于子宫动脉栓塞下刮宫术后镇痛效果良好。

Objective To observe the effect of postoperative analgesia of flurbiprofen axetil and tramadol for patients with artificial abortion after the uterine artery embolism （UAE） for cesarean scar pregnancy （CSP） using patient controlled intravenous analgesia （PCIA） mode. Methods Fifty four ASA I or II female patients with artificial abortion after UAE for CSP were randomly assigned to three groups （each group, n=18）. Group F （flurbiprofen axetil, the concentration is 2.5 mg/ml） received a loading dose 1 mg/kg, bolus 5 mg and background 7.5 mg/h, lockout time 15min. Group T （tramadol, the concentration is 5 mg/ml） received a loading dose 1 mg/kg, bolus 10 mg, background 15 mg/h, lockout time 15 min. Group C （physiological saline） received a loading dose 5 ml, bolus 2 ml and background 3 ml/h. VAS of pain, heart rate （HR）, mean artery pressure （MAP） and the times required for supplemental bolus were recorded before and after operation 1, 4, 8, 12, 24 h. Results There were no significant difference in VAS, HR and MAP between group F and group T. There were significant differences in VAS, HR, MAP and times of bolus between group C and the other groups （P〈0.05 or P〈 0.01）, there was no difference in PONV among three groups. Conclusion Both flurbiprofen axetil and tramadol can be used to postoperative analgesia after artificial abortion with UAE for CSP.