舒芬太尼联合氟比洛芬酯在功能性内窥镜鼻窦手术后患者静脉自控镇痛中的应用效果观察

Efficacy of sufentanil combined with flurbiprofen axetil in patients with patient-controlled intravenous analgesia after functional endoscopic sinus surgery

目的探讨舒芬太尼联合氟比洛芬酯在功能性内窥镜鼻窦手术(FESS)后患者静脉自控镇痛(PCIA)中的应用效果。方法选取78例FESS患者为研究对象,按随机数字表法分为对照组和观察组,各39例。对照组行舒芬太尼PCIA,观察组行舒芬太尼联合氟比洛芬酯PCIA。对比两组镇痛效果、镇静效果、应激反应、PCIA使用情况及不良反应发生率。结果观察组术后3、6、12 h时视觉模拟评分法(VAS)评分为(3.58±0.42)、(2.39±0.32)、(1.85±0.24)分,Ricker镇静-躁动评分(SAS评分)为(4.24±0.45)、(3.46±0.37)、(2.83±0.22)分,均低于对照组的(4.12±0.51)、(3.08±0.41)、(2.31±0.29)分和(4.95±0.59)、(4.01±0.38)、(3.39±0.35)分(P<0.05);观察组术后24 h时皮质醇(COR)、去甲肾上腺素(NE)、促肾上腺皮质激素(ACTH)水平分别为(181.62±18.74)μg/L、(230.14±25.59)ng/L、(10.12±1.53)ng/L,均低于对照组的(204.36±19.75)μg/L、(251.52±26.43)ng/L、(12.96±1.62)ng/L(P<0.05);观察组按压次数、实际有效进药次数分别为(7.41±1.12)、(4.15±0.67)次/24 h,少于对照组的(9.69±1.27)、(5.25±1.05)次/24 h(P<0.05);两组不良反应发生率对比差异无统计学意义(P>0.05)。结论舒芬太尼联合氟比洛芬酯在FESS患者术后PCIA中应用价值高,可提高患者镇痛、镇静效果,减轻机体应激反应,减少PCIA按压次数,安全可靠。

Objective To explore the effect of sufentanil combined with flurbiprofen axetil in patients with patient-controlled intravenous analgesia(PCIA)after functional endoscopic sinus surgery(FESS).Methods A total of 78 FESS patients were selected as the study subjects and divided into a control group and an observation group according to random number table method,with 39 cases in each group.The control group received sufentanil for PCIA,and the observation group received sufentanil combined with flurbiprofen axetil for PCIA.The analgesic effect,sedation effect,stress reaction,use of PCIA and incidence of adverse reactions were compared between the two groups.Results At 3,6 and 12 h after surgery,the observation group had visual analogue scale(VAS)scores of(3.58±0.42),(2.39±0.32)and(1.85±0.24)points,sedation-agitation scale(SAS)scores of(4.24±0.45),(3.46±0.37)and(2.83±0.22)points,which were lower than(4.12±0.51),(3.08±0.41),(2.31±0.29)points and(4.95±0.59),(4.01±0.38),(3.39±0.35)points in the control group(P<0.05).At 24 h after surgery,the levels of cortisol(COR),norepinephrine(NE)and adrenocorticotrophic hormone(ACTH)in the observation group were(181.62±18.74)μg/L,(230.14±25.59)ng/L and(10.12±1.53)ng/L,which were lower than(204.36±19.75)μg/L,(251.52±26.43)ng/L and(12.96±1.62)ng/L in the control group(P<0.05).The number of PCIA compression and the actual effective times of administration in the observation group were(7.41±1.12)and(4.15±0.67)times/24 h,which were less than(9.69±1.27)and(5.25±1.05)times/24 h in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Sufentanil combined with flurbiprofen axetil has high application value in postoperative PCIA in patients with FESS,which can improve the analgesic and sedative effects of patients,reduce the stress response of the body,reduce the number of PCIA compression,and is safe and reliable.