舒芬太尼复合氟比洛芬酯在高血压患者术后静脉自控镇痛中的应用效果观察

Application effect observation of Sufentanil combined with Flurbiprofen Axetil in postoperative controlled intravenous analgesia in hypertensive patients

目的探讨舒芬太尼复合氟比洛芬酯在高血压患者术后静脉自控镇痛中的临床效果。方法选取2013年4月~2016年4月在我院行全身麻醉下腹部手术的60例高血压患者(ASAⅠ~Ⅱ级)作为研究对象,随机分为A组和B组,各30例。A组采用舒芬太尼+托烷司琼+生理盐水,B组采用舒芬太尼+氟比洛芬酯+托烷司琼+生理盐水。比较两组术后4、8、24、48 h不同时段的VAS评分、镇静评级以及恶心呕吐评级,记录各时点的PCA有效/实际按压次数比值、动脉收缩压、心率以及镇痛药消耗量。结果 B组术后8、24、48 h的VAS评分、PCA有效/实际按压次数比值及动脉收缩压显著低于A组,差异有统计学意义(P<0.05)。A组术后4、8、24、48 h镇静程度达2级或以上者所占比例显著高于B组,差异有统计学意义(P<0.05)。结论针对高血压患者,术后采用舒芬太尼复合氟比洛芬酯予以自控镇痛,能够明显减少舒芬太尼的剂量及不良反应,降低围术期高血压的发生。

Objective To explore the clinical effect of Sufentanil combined with Flurbiprofen Axetil in postoperative controlled intravenous analgesia in hypertensive patients.Methods 60 patients with hypertension underwent abdominal surgery （ASA I - lI ） under general anesthesia from April 2013 to April 2016 in our hospital were selected and randomly divided into group A and group B,30 cases in each group.Group A was given Sufentanil ＋ Tropisetron ＋ Normal Saline, group B was given Sufentanil ＋ Flurbiprofen ＋ Tropisetron ＋ Normal Saline.The VAS score,sedation rating and nausea and vomiting rating at different time of 4,8,24,48 hours after operation in the two groups were compared,and the ratio of PCA effective/actual compression times,the arterial systolic blood pressure,heart rate and consumption of analgesics were recorded at each time point.Results The VAS score,the ratio of PCA effective/actual compression times and the arterial systolic blood pressure at different time of 8,24,48 hours after operation in group B was lower than that in group A,with significant difference （P〈0.OS）.The proportion of patients who reached 2 or above sedation level at different time of 4,8,24,48 hours after operation in group A was higher than that in group B,with significant difference （P〈0.05）.Conclu- sion In hypertensive patients,postoperative use of Sufentanil combined with Flurbiprofen Axetil to analgesia can signifi- cantly reduce the dose of Sufentanil and adverse reaction,reduce the incidence of hypertension in perioperative period.