氟比洛芬酯对胸腔镜手术患者术后慢性疼痛的影响

Effect of flurbiprofen axetil on postoperative chronic pain in patients undergoing video-assisted thoracoscopic surgery

目的研究氟比洛芬酯对胸腔镜手术(VATS)患者术后慢性疼痛的影响。方法选取2019年9月至2021年3月安徽理工大学第一附属医院收治的需实施VATS的患者60例作为研究对象。按照随机数字表法分为观察组和对照组,各30例。对照组术毕前30 min静脉注射同等剂量0.9%氯化钠注射液,术毕时连接镇痛泵采用舒芬太尼术后镇痛;观察组术毕前30 min静脉注射氟比洛芬酯50 mg,术毕时连接镇痛泵采用氟比洛芬酯和舒芬太尼术后镇痛。观察术后24、48 h急性疼痛和术后3、6个月慢性疼痛发生情况及患者睡眠质量和镇痛满意度评分、不良反应发生情况。结果观察组在术后24、48 h静息、运动时疼痛数字评分法(NRS)评分均明显低于对照组,差异均有统计学意义(均P<0.05);2组NRS评分均随时间呈现逐渐降低趋势。观察组补救镇痛次数、舒芬太尼消耗量显著少于对照组,差异均有统计学意义(均P<0.05)。术后3、6个月观察组慢性疼痛发生率均低于对照组[10.0%(3/30)比33.3%(10/30)、6.7%(2/30)比26.7%(8/30)],差异均有统计学意义(χ^(2)=3.535,P=0.028;χ^(2)=3.000,P=0.038)。出院时观察组患者睡眠质量评分和镇痛满意度评分均高于对照组,差异均有统计学意义(均P<0.001)。2组患者均未见严重不良反应,轻微不良反应发生率组间差异均无统计学意义(均P>0.05)。结论氟比洛芬酯在VATS术后急、慢性疼痛的控制方面均存在优势。术后应用氟比洛芬酯可以降低术后慢性疼痛的发生率。

Objective To study the effect of flurbiprofen axetil on chronic post surgical pain in patients undergoing video-assisted thoracoscopic surgery(VATS). Methods Totally 60 patients who underwent VATS in the First Hospital of Anhui University of Science & Technology from September 2019 to March 2021 were selected. According to the random number table method, they were divided into observation group and control group, with 30 cases in each group. In the control group, the same dose of 0.9% sodium chloride injection was injected intravenously 30 min before the end of operation. After operation, the analgesic pump with sufentanil was connected at the end of operation for postoperative analgesia. In the observation group, 50 mg flurbiprofen axetil was injected intravenously 30 min before the end of operation, and the analgesic pump with flurbiprofen axetil and sufentanil was connected at the end of operation for postoperative analgesia. The occurrence of acute pain at 24 and 48 h after operation, chronic pain at 3 and 6 months after operation, sleep quality, analgesic satisfaction score and adverse reactions were observed. Results Pain numerical rating scale(NRS) scores during rest and exercise in the observation group 24 and 48 h after operation were significantly lower than those in the control group(all P<0.05);NRS scores of the two groups decreased gradually with time. The times of remedial analgesia and the consumption of sufentanil in the observation group were significantly lower than those in the control group(both P<0.05). The incidences of chronic pain in the observation group were lower than those in the control group 3 and 6 months after operation[10.0%(3/30) vs 33.3%(10/30), 6.7%(2/30) vs 26.7%(8/30)](χ^(2)=3.535, P=0.028;χ^(2)=3.000, P=0.038). At discharge, the scores of sleep quality and analgesic satisfaction in the observation group were higher than those in the control group(all P<0.001). No serious adverse reaction was found in both groups, and there was no significant difference in the incidence of mild adverse reactions between the two groups(all P>0.05). Conclusions Flurbiprofen axetil has advantages in the control of acute and chronic pain after VATS. Postoperative application of flurbiprofen axetil can reduce the incidence of chronic post surgical pain.