氟比洛芬酯联合地塞米松对甲状腺术后疼痛和恶心、呕吐的治疗作用

Effects of Flurbiprofen Axetil Combined with Dexamethasone on Postoperative Analgesia and Preventing Nausea and Vomiting in Patients Undergoing Thyroid Surgery

目的观察氟比洛芬酯复合地塞米松对甲状腺手术后疼痛和恶心、呕吐的治疗作用。方法100例ASA为Ⅰ～Ⅱ级甲状腺手术病人分为5组，每组20例，各组病人在麻醉诱导后手术开始前15min分别静脉注射生理盐水5mL，氟比洛芬酯50mg，地塞米松5mg和氟比洛芬酯50mg，地塞米松10mg和氟比洛芬酯50mg，地塞米松15mg和氟比洛芬酯50mg。手术结束后2、4、8、12、24和48h应用视觉模拟（VAS）评分法评估切口疼痛程度，观察术后恶心、呕吐的发生率。结果术后2h各组的VAS评分没有明显差别（P〉0．05），术后4、8、12、24hⅡ组的VAS评分低于Ⅰ组，Ⅲ组低于Ⅱ组，但无统计学意义（P〉0．05）；Ⅲ组低于Ⅰ组（P〈0．05），Ⅳ和Ⅴ组VAS均明显低于Ⅰ组、Ⅱ组（P〈0．01）和Ⅲ组（P〈0．05），术后48h各组的VAS评分无明显区别（P〉0．05）。术后0～2h内各组均无恶心、呕吐发生，2～48h内各组发生恶心、呕吐的例数分别为9、8、3、2、3，应用地塞米松组恶心、呕吐明显低于未用地塞米松组（P〈0．05）。结论甲状腺手术开始前给予氟比洛芬酯50mg和地塞米松10mg，可以获得术后较好的镇痛、止吐效果。

Objective To observe the effects of flurbiprofen axetil combined with dexamethasone on postoperative analgesia and preventing nausea and vomiting in patients undergoing thyroid surgery.Method 100 patients with ASA Ⅰ-Ⅱ undergoing selective thyroid surgery were randomly divided as Ⅰ-Ⅴ five groups（20 patients in each group）.The Ⅰ-Ⅴ groups of patients were sequentially intravenously injected normal saline 5mL,flurbiprofen axetil 50mg,dexamethasone 5mg combined with flurbiprofen axetil 50mg,dexamethasone 10mg combined with flurbiprofen axetil 50mg and dexamethasone 15mg combined with flurbiprofen axetil 50mg,respectively after induction of anesthesia and 15min before the start of surgery to evaluate the visual analog applications（VAS） scores and record the incidence of postoperative nausea and vomiting at 2,4,8,12,24 and 48 hour after the end of surgery.Result There were no differences in VAS scores at 2h and 48h after the end of surgery in all five groups（P 〉 0.05）;VAS scores in Group Ⅱ were lower than Group Ⅰ and Group Ⅲ were lower than Group Ⅱ at 4,8,12 and 24h after the end of surgery, but without significantly differences（P 〉 0.05）;VAS scores in Group m were significantly lower than scores in Group Ⅰ（P 〈 0.05）,in Group Ⅳ and Ⅴ were significantly lower than scores in Group Ⅱ, Ⅰ（P 〈 0.01） and Ⅲ（P 〈 0.05）.There were no nausea and vomiting in five groups at 0 - 2h after the end of surgery, the number of patients with nausea and vomiting were 9,8,3,2,3 respectively, groups with dexamethasone reduced nausea and vomiting significantly compared with no dexamethasone（P 〈 0.05）. Conclusion Giving flurbiprofen axetil 50mg combined with dexamethasone 10mg before the start of thyroid surgery can receive better analgesia and antiemetic effects after operation.