不同剂量氟比洛芬酯用于小儿单侧腹股沟斜疝修补术后的镇痛效果

Analgesic effect of different dose of flurbiprofen axetil on postoperative unilateral indirect inguinal herniorrhaphy

目的研究不同剂量氟比洛芬酯用于小儿腹股沟斜疝手术术后镇痛的效果评价。方法择期行小儿单侧腹股沟斜疝修补术的患儿100例,年龄3-8岁,美国标准协会（ASA）分级Ⅰ~Ⅱ级。按患儿体质量及氟比洛芬酯注射液使用剂量的不同分为5组,分别为0.5 mg·kg^-1组（A组）、1.0 mg·kg^-1组（B组）、1.5 mg·kg^-1组（C组）、2.0 mg·kg^-1组（D组）及空白对照组（E组）,每组20例。比较其术后镇痛效果及不良反应。结果 5组患儿手术时间比较差异无统计学意义（P〉0.05）。术后不同时点,视觉模拟评分（VAS）A、B、C、D组显著低于E组（P〈0.05）,B、C、D组显著低于A组（P〈0.05）,C组显著低于B组（P〈0.05）,D组与C组比较差异无统计学意义（P〉0.05）。术后不同时点5组患儿心率和呼吸频率比较差异无统计学意义（P〉0.05）。C组各时点恶心、呕吐、腹痛、腹泻等不良反应发生例数均显著少于D组（P〈0.05）。结论氟比洛芬酯以1.5 mg·kg^-1剂量用于小儿单侧腹股沟斜疝修补术术后镇痛效果较好,继续增大其剂量镇痛效果无明显改善,相反会带来明显不良反应,增加术后风险。

Objective To search the analgesic effect of different dose of flurbiprofen axetil on postoperative unilateral indirect inguinal herniorrhaphy. Methods A total of 100 patients who had unilateral indirect inguinal herniorrhaphy were selected in the study. Their age ranged from 3- 8 years old and American Society of Anesthesiologists（ ASA） grade were Ⅰ-Ⅱ. According to different weight and dose of flurbiprofen axetil,the patients were divided into 5 groups randomly with 20 patients in each group. The used dose of flurbiprofen axetil in the 5 groups were 0. 5 mg·kg- 1（ group A）,1. 0 mg·kg- 1（ group B）,1. 5 mg·kg- 1（ group C）,2. 0 mg·kg- 1（ group D） and 0 mg·kg- 1（ group E）. The analgesic effect after operation and adverse reactions of the groups were compared. Results There was no statistical significance for the operation time among the 5 groups（ P〈0. 05）. In different postoperative time point,the visual analogue scale（ VAS） in group A,B,C and D were lower significantly than that in group E（ P〈0. 05）. VAS in group B,C and D were lower significantly than that in group A（ P〈0. 05）,which in group C was lower significantly than that in group B（ P〈0. 05）. But there was no significant difference between group D and group C（ P〈0. 05）. Heart rate and respire rate in the 5 groups had no statistical significance in the different postoperative time point（ P〈0. 05）. The happening of nausea,vomiting,abdominal pain and diarrhea in group D were more significantly than that in group C（ P〈0. 05）. Conclusion The flurbiprofen axetil dose of 1. 5 mg·kg- 1has better analgesic effect for the postoperative unilateral indirect inguinal herniorrhaphy in children. If the dosage of flurbiprofen axetil is continued increasing,the analgesic effect has no significantly improved,on the contrary,it will bring obvious adverse reactions and increase the postoperative risk.