氟比洛芬酯超前镇痛对小腿骨骨折术后芬太尼镇痛效果的影响

Effect of flurbiprofen axetil preemptive analgesia on postoperative fentanyl analgesia in lower leg fracture

目的观察术前注射氟比洛芬酯联合术后芬太尼自控镇痛的临床效果。方法将该院2008年1月至2011年12月收治的小腿胫骨或腓骨骨折患者102例,随机分为观察组(术前氟比洛芬酯联合术后芬太尼)和对照组(术前脂微球注射液联合术后芬太尼),各51例。观察两组患者术前及术后24h的生命体征,记录术后24h视觉模拟评分法(VAS)评分及芬太尼用量,并观察患者的各种不良反应表现。结果两组患者手术前后生命体征(BP、HR、SpO2、RR)比较,差异无统计学意义(P>0.05);手术后2、4、6、12、24h的VAS评分比较,差异无统计学意义(P>0.05);对照组和观察组术后24h内不良反应发生率分别为21.6%、3.9%,差异有统计学意义(P<0.01);手术后24h对照组和观察组芬太尼用量分别为(736.0±50.4)、(437.3±38.1)μg,两组比较差异有统计学意义(P<0.05)。结论小腿胫骨或腓骨骨折术前静脉注射氟比洛芬酯可减少术后芬太尼用量,减少不良反应的发生,值得临床推广。

Objective To observe the clinical effect of preoperative injection of flurbiprofen axetil combined with postoperative patient controlled analgesia with fentanyl. Methods 102 cases of tibia fracture or fibula fracture treated in our hospital from January 2008 to December 2011 were randomly divided into the observation group（preoperative flurbiprofen plus postoperative fentanyl） and the control group（preoperative lipid microsphere injection plus postoperative （entanyl） ,51 cases in each group. The vital signs at preoperative and postoperative 24 h were observed. The visual analog scale（VAS） scores at postoperative 24 h and use a- mounts of fentanyl were recorded. Various manifestations of adverse reactions were observed. Results The vital signs （BP, HR, SpO2, RR） had no statistical difference between the two groups（P^0.05）. Comparison of the VAS scores at postoperative 2,4,6, 12,24 h showed no statistical difference between the two groups（P〈0.05）. The incidence rate of adverse reactions at postoperative 24 h was 21.6% in the control group and 3.9~ in the observation group with statistical difference（P〈0.01）. The use amounts of fentanyl at postoperative 24 h were（736±50.4）μg and（437.3±38.1） μg,showing statistical difference between the two groups（P 〈0.05）. Conclusion Preoperative injection of flurbiprofen in tibia or fibula fracture may reduce the use amounts of postoperative fentanyl and the occurrence of adverse reactions,which is worthy of clinical popularization.