氟比洛芬酯复合芬太尼用于乳腺癌根治术术后静脉镇痛的效果观察

Observation on the effect of flurbiprofen axetil combined with fentanyl for radical mastectomy postoperative intravenous analgesia

目的:比较氟比洛芬酯复合芬太尼与单纯芬太尼在乳腺癌根治术术后静脉镇痛的效果与不良反应。方法:乳腺癌患者60例,术后均患者自控静脉镇痛(PCIA)。随机分为2组,每组30例。芬太尼组(Ⅰ组)术后镇痛给予芬太尼1.0 mg+盐酸昂丹司琼注射液8 mg+生理盐水100 ml;氟比洛芬酯复合芬太尼组(Ⅱ组)于缝皮前给予氟比洛芬酯50 mg,术后镇痛给予芬太尼0.5 mg+氟比洛芬酯250 mg+盐酸昂丹司琼注射液8 mg+生理盐水100 ml。2组PCIA泵的设置相同:维持量2 ml/h,单次给药量0.5 ml,锁定时间15 min。观察2组患者术后12、24、48 h的镇痛、镇静评分和不良反应发生率。结果:除术后48 hⅡ组患者镇痛评分低于Ⅰ组(P<0.05)外,其余不同时间的镇痛、镇静评分在2组间差异均无统计学意义(P>0.05);Ⅱ组不良反应发生率20.0%低于Ⅰ组46.7%(P<0.05)。结论:氟比洛芬酯复合芬太尼用于乳腺癌根治术术后静脉镇痛效果与单纯芬太尼相似,但不良反应发生率明显降低。

Objective：To compare the effects and adverse reactions of flurbiprofen axetil combined with fentanyl in radical mastectomy for breast cancer postoperative intravenous analgesia. Methods： Sixty cases of breast cancer patients after operation treated with patient- controlled intravenous analgesia （PCIA） were randomly divided into two groups, 30 cases in each group, group I , postoperative analgesia with fentanyl was given fentanyl 1.0 mg and ondansetron hydrochloride injection in 8 mg and normal saline 100 ml;group Ⅱ was given lurbiprofen axetil 50 mg before skin suture,postoperative analgesia was given fentanyl 0.5 mg and lurbiprofen axetil 250 mg and ondansetron injection 8 mg and normal saline 100 ml. Two groups of PCIA pump set the same：maintenance dose of 2 ml/h, a single dose of 0.5 ml,locking time 15 min. Analgesia,sedation scores and the incidence of adverse reactions of two groups were observed in 12,24,48 hour. Results：Except for group I1 less than group I （P 〈0.05 ）in analgesia scores in postoperative 48 hours,the rest of different duration of analgesia, sedation score between the 2 groups had no significant difference（P 〉0.05 ） ;group Ⅱ adverse reaction rate（20.0% ） was lower than in group I （46.7%） （P 〈0.05）. Conclusions：Tbe effect of flurbiprofen axetil combined with fentanyl in radical mastectomy for breast cancer postoperatiye intravenous analgesia with fentanyl is similar, but adverse reaction is significantly reduced.