氟比洛芬酯联合右美托咪定强化麻醉对甲状腺手术患者术后疼痛的临床效果分析

Analysis of clinical effect of flurbiprofen axetil combined with dexmedetomidine intensive anesthesia on postoperative pain in patients undergoing thyroid surgery

目的探讨氟比洛芬酯联合右美托咪定强化麻醉在甲状腺手术患者术后疼痛中的临床效果。方法选取162例行甲状腺手术的患者为研究对象,采用随机数表法将患者分为对照组和研究组,每组81例。对照组患者采用右美托咪定进行强化麻醉,研究组患者在对照组的基础上增加氟比洛芬酯进行强化麻醉。比较两组患者不同时间点[静脉通路基础值(T0)、手术完成后(T1)]的各项生命体征,不同时间点[术后2 h(T2)、术后4 h(T3)、术后8 h(T4)、术后12 h(T5)]的疼痛、镇静评分,麻醉苏醒时间,不良反应发生情况。结果研究组患者T1时的平均动脉压、脉搏氧饱和度、呼吸频率与本组T0时比较差异无统计学意义(P>0.05);对照组患者T1时的呼吸频率与本组T0时及研究组T1时比较差异无统计学意义(P>0.05),但对照组T1时的平均动脉压(66.56±7.15)mm Hg(1 mm Hg=0.133 kPa)、脉搏氧饱和度(82.28±10.87)%显著低于本组T0时的(78.55±8.27)mm Hg、(98.64±10.13)%及研究组患者T1时的(78.29±8.52)mm Hg、(96.32±10.88)%,差异具有统计学意义(P<0.05)。研究组患者T2、T3、T4、T5时的疼痛评分分别为(2.41±0.36)、(2.25±0.32)、(1.67±0.30)、(1.67±0.30)分,镇静评分分别为(2.16±0.29)、(2.14±0.26)、(1.89±0.20)、(1.46±0.18)分,均显著低于对照组的(2.96±0.48)、(2.93±0.46)、(2.93±0.43)、(2.91±0.38)分及(2.86±0.46)、(2.78±0.40)、(2.14±0.24)、(2.10±0.21)分,差异具有统计学意义(P<0.05)。两组患者的麻醉苏醒时间比较差异无统计学意义(t=1.451,P=0.149>0.05)。两组患者的不良反应发生率比较差异无统计学意义(χ^(2)=0.228,P=0.633>0.05)。结论右美托咪定联合氟比洛芬酯强化麻醉应用于甲状腺手术患者中,可显著降低患者的疼痛程度,不影响患者的苏醒时间及生命体征,且临床安全性良好,值得推广使用。

Objective To explore the clinical effect of flurbiprofen axetil combined with dexmedetomidine intensive anesthesia on postoperative pain in patients undergoing thyroid surgery.Methods 162 patients undergoing thyroid surgery were selected as the study subjects,and the patients were divided into a control group and a study group by random number table method,with 81 cases in each group.The control group received dexmedetomidine for intensive anesthesia,and the study group received flurbiprofen axetil for intensive anesthesia on the basis of the control group.Patients in both groups were compared in terms of vital signs at different time points[basic value of venous access(T0),after completion of surgery(T1)],pain and sedation score at different time points[2 h postoperatively(T2),4 h postoperatively(T3),8 h postoperatively(T4),and 12 h postoperatively(T5)],anesthesia recovery time,and adverse reactions.Results In the study group,the differences in mean arterial pressure,pulse oxygen saturation,and respiratory rate at T1 were not statistically significant when compared to that at T0(P>0.05).There was no significant difference in respiratory rate at T1 in the control group when compared with that at T0 in this group and that at T1 in the study group(P>0.05).However,the mean arterial pressure of(66.56±7.15)mm Hg(1 mm Hg=0.133 kPa)and pulse oxygen saturation of(82.28±10.87)%in the control group were significantly lower than(78.55±8.27)mm Hg and(98.64±10.13)%at T0 in this group,and(78.29±8.52)mm Hg and(96.32±10.88)%at T1 in the study group.The difference was statistically significant(P<0.05).In the study group,the pain scores at T2,T3,T4,T5 were(2.41±0.36),(2.25±0.32),(1.67±0.30),(1.67±0.30)points,the sedation scores were(2.16±0.29),(2.14±0.26),(1.89±0.20),(1.46±0.18)points,which were significantly lower than(2.96±0.48),(2.93±0.46),(2.93±0.43),(2.91±0.38)points and(2.86±0.46),(2.78±0.40),(2.14±0.24),(2.10±0.21)points in the control group.The difference was statistically significant(P<0.05).There was no significant difference in anesthesia recovery time between the two groups(t=1.451,P=0.149>0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.228,P=0.633>0.05).Conclusion The application of flurbiprofen axetil combined with dexmedetomidine intensive anesthesia for patients undergoing thyroid surgery can significantly reduce the degree of pain and suffering without affecting the patients'recovery time and vital signs,and the clinical safety is good,which is worthy of popularization and use.