氟比洛芬酯预防瑞芬太尼麻醉后的痛觉过敏

Flurbiprofen prevent hyperalgesia after remifentanil anesthesia

目的探讨氟比洛芬酯术前给药对瑞芬太尼麻醉后痛觉过敏的影响。方法本研究共纳入本院普外科行上腹部手术的患者96例,男51例,女45例,年龄18~65岁,ASAⅠ或Ⅱ级,按随机数字表法将其分为四组,每组24例。A1和A2组:麻醉前预注氟比洛芬酯1.5mg/kg,B1和B2组:麻醉前不给予氟比洛芬酯,A1和B1组术中以瑞芬太尼0.1μg·kg^(-1)·min^(-1)维持麻醉,A2和B2组术中以瑞芬太尼0.4μg·kg^(-1)·min^(-1)维持麻醉。记录自主呼吸恢复时间、意识恢复时间及拔管时间,恶心,呕吐,躁动,麻醉苏醒后5min的疼痛VAS评分。结果四组患者自主呼吸恢复时间、意识恢复时间及拔管时间差异无统计学意义。B2组苏醒后VAS评分最高(9.0±1.8)分,明显高于其它三组(P<0.05)。A1组VAS评分最低(3.1±1.1)分,明显低于其它三组(P<0.05)。结论上腹部手术时术前给予氟比洛芬酯1.5mg/kg可减轻瑞芬太尼麻醉后的痛觉过敏。

Objective To investigate the influence of pre-administration of flurbiprofen on the hyperalgesia after remifentanil anesthesia.Methods This study included a total of 96 patients with abdominal surgery in the department of general surgery of our hospital.According to the random number table method,they were divided into 4 groups （n =24）.Flurbiprofen axetil 1.5 mg/kg was injected intravenously before anesthesia in groups A1 and A2,flurbiprofen axetil was not injected in-travenously before anesthesia in groups B1 and B2.Anesthesia was maintained with infusion of remifentanil 0.1 μg·kg-1 ·min-1 in groups A1 and B1 0.4 μg·kg-1 ·min-1 in groups A2 and B2. The spontaneous breathing recovery time, consciousness recovery time,extubation time and anesthesia recover period of nausea,vomiting,restlessness and pain VAS scores were recorded. Results There was no significant difference in breath recovery time,consciousness recovery time and extubation time between the four groups.VAS score （9.0±1.8）was the highest in group B2,VAS score was significantly higher than the other three groups （P 〈0.05）.VAS score （3.1±1.1）was the lowest in group A1, which was significantly lower than the other three groups （P 〈 0.05 ）. Conclusion Pre-application of flurbiprofen 1.5 mg/kg can reduce postoperative hyperalgesia after remifentanil anesthesia in patients undergoing abdominal surgery.