地佐辛联合瑞芬太尼及氟比洛芬酯用于腹部手术后镇痛效果的临床观察

Clinical observation on the efficiency of dezocine with remifentanil and flurbiprofen for abdominal postoperative analgesia

目的:评价地佐辛联合瑞芬太尼及氟比洛芬酯用于腹部手术后镇痛的效果及安全性。方法:择期腹部手术患者80例,ASAⅠⅡ,随机分为2组,每组40例。术后患者使用自控镇痛泵,对照组使用瑞芬太尼0.1 mg+氟比洛芬酯100 mg;观察组使用地佐辛25 mg+瑞芬太尼0.05 mg+氟比洛芬酯100 mg。患者采用咪达唑仑、依托咪酯、罗库溴胺诱导麻醉,丙泊酚维持麻醉,术闭前10 min静脉给予氟比洛芬酯50 mg。记录患者术后4,8,24,48 h静息状态和活动状态下的VAS疼痛评分、Ramsay镇静评分,48 h内恶心、呕吐、呼吸抑制等不良反应。结果:观察组患者术后4,8,24,48 h静息和活动时的VAS评分都低于对照组(P<0.05)。术后48 h内镇静评分,观察组患者优于对照组(P<0.05)。术后48 h内的不良反应观察组较对照组少(P<0.05)。结论:地佐辛25 mg+瑞芬太尼0.05 mg+氟比洛芬酯100 mg术后持续镇痛48 h效果优于等效剂量瑞芬太尼与氟比洛芬酯联合应用,且不良反应明显减少。

OBJECTIVE To evaluate the efficiency and safety of dezocine with remifentanil and flurbiprofen for abdominal postoperative analgesia. METItODS 80 patients for elective abdominal operation, ASA l - 1I, were randomly divided into two groups, each group had 40 patients. The recipe in the independent intravenous analgesic pump was： control group, remifentanil 0. 1 mg ＋ flurhiprofen 100 mg; observation group,dezocine 25 mg ＋ remifentanil 0. 05 mg ＋ flurbiprofen !00 mg anesthesia was induced by midazolam, etomidate and rocuronium, maintained with propofol. 10 min before the end of surgery, flurbiprofen 50 mg was given IV. Pain relief scores, sedation and side effects were recorded at 4,8,24,48 h after surgery. RE- SULTS Significantly higher pain relief scores （P〈0. 05） were reported for the observation group than the control group at all observation times. Significantly better sedation scores were shown in observation group （P〈0. 05）. During the observation pe- riod, side effects happened in observation group were less than those in control group （P〈0.05）. CONCLUSION Dezocine 25 mg ＋ remifentanil 0. 05 mg ＋ flurbiprofen 100 mg group is better to relief the postoperative pain, and with less adverse effects.