脊柱侧弯患者术后早期应用凯纷与曲马多镇痛的效果比较

Comparative analysis of the analgesic effect of flurbiprofen acetate injection and tramadol for patients with scoliosis after surgery

目的 比较凯纷与曲马多单次静脉给药对于脊柱侧弯患者术后早期镇痛的临床效果及不良反应。方法 将该院2011年9月至2013年2月收治的进行脊柱侧弯术的92例患者作为研究对象,完全随机分为凯纷组、曲马多组,每组各46例,两组均采用气管插管静脉全身麻醉。手术结束前10min,凯纷组患者静脉注射凯纷1mg/kg,曲马多组患者静脉注射曲马多1mg/kg。观察并记录两组术前（T0）,给药时（T1）,拔管时（T2）,拔管后5min（T3）,拔管后10min（T4）,拔管后30min（T5）及拔管后1h（T6）患者的生命体征,以及T3~T6的疼痛评分,观察用药后患者的不良反应。结果 凯纷组T3~T6的疼痛评分均低于同时段曲马多组,且T3、T4、T5时间点时凯纷组疼痛评分明显低于曲马多组,差异有统计学意义（P〈0.05）,T6时差异无统计学意义（P〉0.05）;凯纷组有3例患者发生不良反应,占6.52%,远低于曲马多组的11例（23.91%）,差异有统计学意义（P〈0.05）;凯纷组恶心呕吐评分为（0.39±0.21）分,明显低于曲马多组的（1.17±0.14）分,二者差异有统计学意义（P〈0.01）;T2及T3时凯纷组心率的变化小于曲马多组,差异有统计学意义（P〈0.05）,其他时间点差异无统计学意义（P〉0.05）;血压及血氧饱和度各时间点的差异无统计学意义（P〉0.05）。结论 脊柱侧弯患者术后早期镇痛中凯纷的效果优于曲马多,且生命体征更为稳定,不良反应少,具有一定的临床价值。

Objective To compare the effect of offlurbiprofen acetate injection and tramadol for early postoperative analgesia and side effects after scoliosis surgery.Methods A total of 92 patients treated with scoliosis surgery from September 2011 to February 2013 were selected as subjects in this study,divided into flurbiprofen acetate injection group and tramadol group randomly,46 patients in each group.All the patients were all treated with intravenouos anesthesia endotracheal intubation.The flurbiprofen acetate injection group were injected flurbiprofen acetate（1mg/kg）and the tramdo group were injected tramdo（2mg/kg）10min before the end of operation.The analgesic efficacy and side effects were observed and recorded before operation（T0）,after administration（T1）,when the tube drawing（T2）,after extubation 5（T3）,10（T4）,30（T5）,60（T6）min after extubation.Results The pain scores at T3,T4,T5 in flurbiprofen acetate injection group were lower than those at the same segment in tramado group（P〈0.05）,but no significant different found at T6（P〈0.05）.There were three patients（6.52%）with side effects in flurbiprofen acetate injection group,the incidence rate was significant lower than tramado group（23.91%）（P〈0.05）.The nausea and vomiting score in flurbiprofen acetate injection group（0.39±0.21）was significant lower than that of tramadol group（1.17±0.14）,the difference was significant（P〈0.05）.The heart rates at T2 and T3in flurbiprofen acetate injection group were less than those of tramadol group,the difference was significant（P〉0.05）,there were no significant differences on other time points（P〉0.05）.There were no significant differences on blood pressure and blood oxygen saturation on different time points（P〈0.05）.Conclusion Analgesia effect of flurbiprofen acetate injection is significant better than tramadol for scoliosis surgery,and patients using flurbiprofen acetate injection has more stable vital signs,less adverse reactions.