氟比洛芬酯复合舒芬太尼用于骨科术后镇痛的临床研究

The Clinical Research of Postoperative Analgesia with Flurbiprofen Axeyil Combined with Sufentanil in Patients Undergoing Orthopaedic Surgery

目的:观察氟比洛芬酯复合舒芬太尼用于骨科手术术后镇痛的临床效应。方法:择期骨科手术患者90例,随机分为三组。A组手术结束前15min静注5ug舒芬太尼,后以舒芬太尼3ug/kg、托烷司琼8mg加生理盐水至200 ml进行镇痛;B组手术结束前15min静注氟比洛芬酯50 mg/(5 ml),术后以舒芬太尼2ug/kg、托烷司琼8mg、氟比洛芬酯100mg加生理盐水至200 ml进行镇痛;C组手术结束前15min静注氟比洛芬酯50 mg/(5 ml),术后以舒芬太尼1ug/kg、托烷司琼8mg、氟比洛芬酯100mg加生理盐水至200 ml进行镇痛。所有患者的镇痛泵均为4 ml/h,持续输注。术后随访病人,记录术后(4、8、12、24、48)h的疼痛、镇静评分。随访时同时记录:①生命体征;②各种不良反应情况包括恶心呕吐、皮肤瘙痒、呼吸抑制等。结果:A组和B组在镇痛效果上无显著差异,B组和C组比较在术后4小时和8小时VAS评分B组优于C组;A组镇静在术后4、8h评分达3分以上者明显多于B组、C组,有显著性差异(P<0.05);不良反应情况:三组病人术后生命体征平稳,均未出现严重呼吸循环抑制、皮肤瘙痒及异常出血等严重并发症,A组不良反应发生率高于B、C组(P均<0.01)。结论:氟比洛芬酯与舒芬太尼联合应用于术后镇痛可以达到满意的镇痛效果,同时减少了围术期不良反应的发生,是一种值得临床推广的安全有效的镇痛方法。

Objective：To observe the clinical effects of flurbiprofen axeyil combined sufentanil in postoperative analgesia of orthopaedic surgery patients.Methods：Ninety cases of patients undergoing elective orthopedic surgery, were randomly divided into three groups. In group A, there was the intravenous infusion of sufentanil 3ug/kg＋tropisetron 8mg＋saline, the total amount of 200ml, after the first 5ug sufentanil 15min before the end of surgery. In group B, after the first 50mg/（5 ml） flurbiprofen axeyil 15 min before the end of surgery, there was the intravenous infusion of sufentanil 2ug/kg＋tropisetron 8mg＋flurbiprofen axeyil 100mg＋saline, the total amount of 200ml. In group C, there was the intravenous infusion of sufentanil 1ug/kg＋tropisetron 8mg＋flurbiprofen axeyil 100mg＋saline, the total amount of 200ml, after the first 50mg/（5 ml） flurbiprofen axeyil 15min before the end of surgery . All the analgesia pump are 4 ml/h and continuous infusion. Postoperative analgesia and sedate efficacy was assessed at 4h, 8h, 12h, 24h and 48h after surgery. Also record：（1） vital signs;（2） a variety of adverse reactions include nausea and vomiting, skin itching, respiratory depression, etc.Results：Between group A and group B there was no significant difference on analgesia effect, but the VAS score at 4h and 8h after surgery of group B was better than that of group C;The patients with the sedation scores equal to or greater than 3 in Group A at postoperative 4h and 8h were more than group B and group C, there was significant difference （P〈0.05）;Adverse reactions：three groups of patients had stable vital signs, and did not appear serious respiratory inhibition, itchy skin, and a severe complication such as abnormal bleeding.The incidence of adverse reaction of group A was higher than B and C group （P〈0.01）.Conclusion：Flurbiprofen axeyil combined with sufentanil used in postoperative analgesia can achieve satisfactory analgesia effect, at the same time reduce the perioperative incidence of adverse reactions.It is a kind of safe and effective analgesic method to be worth clinical promotion.