氟比洛芬酯和曲马多对经产妇剖宫产后宫缩痛的效果比较

Comparison of the efficacy of flurbiprofen axetil and tramadol for uterine contraction pain of multiparae after Caesarean operation

目的比较氟比洛芬酯和曲马多对经产妇剖宫产术后子宫收缩痛的镇痛效果。方法选取2019年1~6月来我院腰-硬联合麻醉下行剖宫产、术毕持续硬膜外镇痛、术后子宫收缩痛明显的经产妇80例,随机分为氟比洛芬酯组(F组)和曲马多组(T组)。每组40例,分别以静脉注射氟比洛芬酯或曲马多镇痛处理。观察记录产妇术后出现明显宫缩痛的时间、镇痛药物使用前、使用后5、10、15以及30min的VAS评分、镇痛作用持续的时间以及Ramsay镇静评分。记录出现头晕、恶心、呕吐等不良反应的例数。结果两组经产妇一般情况及出现明显宫缩痛的时间比较差异无统计学意义(P>0.05),F组用药后5min的VAS评分与用药前比较差异无统计学意义(P>0.05),而两组在用药后其他时间点的VAS评分明显低于用药前(P<0.05),F组在用药物后5和10min VAS评分明显高于同时间点T组(P<0.05),两组在用药后15和30min的VAS评分比较差异无统计学意义(P>0.05)。镇痛持续时间F组略优于T组,且差异有统计学意义(P<0.05),两组Ramsay镇静评分差异无统计学意义(P>0.05),出现头晕、呕吐不良反应的例数T组明显高于F组(P<0.05)。结论氟比洛芬酯和曲马多都能够明显减轻经产妇剖宫产术后的子宫收缩痛,氟比洛芬酯起效略慢于曲马多,但维持时间长,不良反应少。

Objective To compare the efficacy of flurbiprofen axetil and tramadol for uterine contraction pain of multiparae after Caesarean operation.Methods 80 multiparae admitted to our hospital from January to June 2019 who underwent Caesarean operation under combined spinal-epidural anesthesia and sustained epidural analgesia after operation with obvious postoperative uterine contractile pain were randomly divided into flurbiprofen axetil group(Group F)and tramadol group(Group T),with 40 cases in each group,who were treated with intravenous flurbiprofen axetil or tramadol respectively to ease pain.Then the time of obvious uterine contraction pain of multiparae after Caesarean operation,VAS scores before the use of analgesic drugs and 5 minutes,10 minutes,15 minutes and 30 minutes after the use of analgesic drugs,duration of analgesic effect and Ramsay sedation scores were observed and recorded.The number of adverse reactions(ADRs)such as dizziness,nausea and vomiting was recorded.Results There was no statistically significant difference between the two multipara groups in the time of the general situation and of obvious uterine contraction pain situation(P>0.05).There was no statistically significant difference in VAS scores of Group F 5 minutes after medication compared with that before medication(P>0.05),while the VAS scores of the two groups at other time points after medication were obviously lower than those before medication(P<0.05).The VAS scores of Group F at 5 minutes and 10 minutes after medication were obviously higher than those of Group T at the same time points(P<0.05).There was no statistically significant difference between the VAS scores of the two groups at 15 minutes and 30 minutes after medication(P>0.05).The duration of analgesia in Group F was slightly better than that in Group T,and the difference was statistically significant(P<0.05).The difference of Ramsay sedation scores between the two groups had no statistical significance(P>0.05).The number of adverse reactions such as dizziness and vomiting in Group T was significantly larger than that in Group F(P<0.05).Conclusion Both flurbiprofen axetil and tramadol can significantly reduce the uterine contractile pain of multiparae after Caesarean operation.Flurbiprofen axetil takes effect slightly slower than tramadol,but the effect is maintained for a longer time with fewer adverse reactions.