氟比洛芬酯超前镇痛预防患儿全麻苏醒期躁动的效果

Preventive effects of preemptive analgesia of flurbiprofen axetil injection on emergence agitation in children

目的：评价氟比洛芬酯超前镇痛预防患儿全凭静脉麻醉下行扁桃体联合腺样体切除术后苏醒期躁动的效果。方法：50例患儿完全随机分为两组：氟比洛芬酯组（F组）和对照组（C组）,各25例,F组麻醉诱导前给予氟比洛芬酯1mg/kg静脉推注,C组静脉推注等量的生理盐水。静脉注射芬太尼2μg/kg、丙泊酚2.0mg/kg、顺阿曲库铵0.15mg/kg快速诱导,行气管内插管术后机械通气。麻醉维持：丙泊酚10~12μg·kg-1·min-1,瑞芬太尼0.2~0.30μg·kg-1·min-1。手术结束前10min,两组患儿均静脉注射氟比洛芬酯0.2mg/kg。记录手术时间、拔除气管导管时间、入麻醉恢复室（RR）后滞留时间;同时记录入RR即刻、10、20、30、60min的躁动评分（PAED）及改良加拿大东安大略儿童医院疼痛评分（m-CHEOPS）;术后1、3、6h的FLACC评分及术毕12h内不良反应发生情况。结果：与C组比较,F组在即刻、10、20min时间点上的躁动满意率明显增加（P〈0.05）;术后各个时间点的FLACC和m-CHEOPS评分,F组均显著低于C组（P〈0.05）。结论：氟比洛芬酯应用超前镇痛术,对预防小儿全凭静脉麻醉苏醒期躁动有确切的预防作用并优于单纯术后镇痛。

Objective：To evaluate the effects of preemptive analgesia of flurbiprofen on emergence agitation from total intravenous anesthesia in children undergoing post-adenotonsillectomy. Methods：fifty children were randomly divided into two groups（n =25）：flurbiprofen group（group F） and control group（group C）. Patients in group F received intravenous administration of flurbiprofen1mg/kg before anesthesia,while those were injected saline in equal volume in group C. Anesthesia of both groups′ patients was induced with fentanyl 2μg/kg, Propofol 2.0mg/kg,and cisatracurium 0.15 mg/kg followed by endotracheal intubation and mechanical ventilation. Anesthesia was maintained with propofol 10 ~12μg·kg-1·min-1and remifentanil 0.2~0.3μg·kg-1·min-1through infusion pump. Flurbiprofen 0.2mg/kg was intravenously injected two groups in 10 min before the end of surgery.The operation time,extubation time,after admitted to recovery room（RR）,residence time at RR,PAED and m-CHEOPS were recorded every 10 min in the first 60 min at the recovery room. FACC scores at postoperative 1,3, 6h and the adverse reaction within 12 h after surgery were recorded. Results：Compared with group C, the PAED scores at immediately,10,20 min and m-CHEOPS scores at every time point after admitted to RR were significantly decreased in group F（P0.05）.the FACC at postoperative 1、3、6h time points in the group F were lower than those group C,showing statistical difference between them（P0.05）.Conclusion：Preemptive analgesia of Flurbiprofen is exactly effective on EA and superior to single postoperative analgesia.