氟比洛芬酯复合芬太尼在口腔肿瘤术后镇痛的临床研究

The postoperative analgesia of flurbiprofen axetil on oral tumor patients

目的观察氟比洛芬酯复合芬太尼用于口腔肿瘤患者术后的镇痛效果。方法选择ASAⅠ或Ⅱ级择期口腔肿瘤手术患者60例,随机均分为氟比洛芬酯组(A组)和芬太尼组(B组)。两组患者均在手术结束前30min静注芬太尼0.05mg,术后均给予患者自控静脉镇痛(PCIA)。A组:氟比洛芬酯200mg、芬太尼0.4mg和格拉司琼6mg,生理盐水稀释至100ml;B组:芬太尼0.8mg和格拉司琼6mg,生理盐水稀释至100ml。两组背景输注2ml/h,PCA0.5ml/次,锁定时间为15min,持续输注48h。观察并记录苏醒时(T0)、术后6h(T1)、12h(T2)、24h(T3)和48h(T4)VAS评分,观察术后恶心、呕吐、嗜睡、头痛头昏、呼吸抑制等不良反应。结果两组患者PCA按压次数为零,两组患者术后各时点VAS评分差异无统计学意义。B组患者恶心、呕吐、嗜睡、头痛头昏、呼吸抑制等不良反应发生率明显高于A组(P<0.05)。结论氟比洛芬酯可安全用于口腔肿瘤手术患者术后镇痛,效果满意,减少芬太尼的用量及不良反应的发生率。

Objective To investigate the postoperative analgesia of flurbiprofen axetil combined with fentanyl for patients with oral tumor, Metlmds Sixty ASA class I or Ⅱ patients with oral tumor were randomly allocated into two groups with 30 cases each, with same anesthesia method in operation. 0. 05 mg fentanyl was infused 30 min before skin incision. Postoperative patient controlled intravenous analgesia（FCIA） was given in both groups The drugs for tK;IA in group A： flurbiprofen axetil 200 mgq-fentanyl 0. 4 mg＋granisetron hydrochloride 6 mg ＋0. 9% NS diluted to 100 ml. The drugs for PCIA in group B： fentanyl 0. 8 rng q- granisetron hydrochlofide 6mg＋0. 9%NS diluted to 100 ml. Tile basal dose of PCIA for both groups was 2 ml/h with 0. 5 ml for each bolus and 15 min Locking time. The pain score and side effect were recorded at 0 h （To）, 6 h（T1）, 12 h（T2）, 24 h（T3 ） and 48 h（T4 ） postoperatively. Results There were no tK2A demands in each group. All groups received satisfactory effect. Group A has less respiratory depression, less side effect than fentanyl group（P〈0. 05）. Conclusion Flurbiprofen axetil could be used safely and effectively in tK;IA for patients with oral tumor surgery, with the dodge and side effect of fentanyl were reduced.