摘要
目的:探讨氟比洛芬酯复合芬太尼用于功能性鼻内窥镜术(FESS)后静脉自控镇痛的可行性及安全性。方法:40例择期行FESS要求术后镇痛的患者,随机分为芬太尼组(F组)和氟比洛芬酯复合芬太尼组(KF组),每组20例。术毕前30 min静注负荷量,F组芬太尼0.05 mg,KF组氟比洛芬酯50 mg,连接镇痛泵。F组药液为芬太尼1.0 mg+昂丹司琼8 mg+0.9%氯化钠注射液共100 mL,KF组为氟比洛芬酯100 mg+芬太尼0.5 mg+昂丹司琼8 mg+0.9%氯化钠注射液共100 mL。均设定背景速度2.0 mL.h-1,患者自控剂量2.0mL,锁定时间15 min。观察并记录术后2,6,24 h的视觉模拟疼痛评分(VAS)、Ramsay镇静评分、PCA按压次数、呼吸频率(RR)、脉搏氧饱和度(SpO2)、血压(BP)及心率(HR),同时记录有无呼吸抑制、头晕、恶心、瘙痒、异常出血等不良反应。结果:2组患者术后各时间点的VAS评分、HR、BP以及SpO2无显著差异;术后2,6,24 h的Ramsay评分KF组均低于F组,而RR均高于F组(P<0.01);不良反应KF组头晕、恶心的发生率明显低于F组(P<0.05)。结论:氟比洛芬酯复合芬太尼用于FESS术后静脉自控镇痛,能够达到满意的镇痛效果,避免芬太尼可能造成的呼吸抑制及过度镇静。
Objective：To investigate the reliability and safety of patient-controlled analgesia with flurbipro- fen and fentanyl after functional endscopic sinus surgey （FESS）. Methods： Forty adult patients received FESS were randomly divided into 2 groups （F and KF） of twenty patients each. Patients received either an intravenous bolus of 0.05 mg fentanyl （ F group） or 50 mg flurbiprofen （ KF group） before connected with analgesia-pump at the end of the surgery. For F group, fentanyl 1.0 mg and ondansetron 8 mg were dissolved in 100 mL saline; for KF group, fentanyl 0.5 rag, firubiprofen 100 mg and ondansetron 8 mg were dissolved in 100 mL saline. The background speed was 2 mL per hour. The patient-controlled analgesia was conducted 2 mL at 15 rain intervals. VAS, Ramsay, PCA frequency, RR, SpO2 , BP and HR were recorded 2, 6 and 24 h after the operation. Adverse effects were observed, such as respiratory depression, dizziness, nausea, pruritus and abnormal bleeding. Results： There was no significant difference between two groups in VAS, HR, BP and SpO2 after the operation. Ramsay was significantly lower, and RR was significantly faster （P 〈0.01 ） in KF group than in F group. The incidence of dizziness and nausea was significantly lower （P 〈 0.05） in KF group than in F group. Conclusion. Patient-controlled analgesia with flurbiprofen and fentanyl after FESS operation is reliable, and avoids respiratory depression and over-sedation induced by fentanyl.
出处
《中国新药杂志》
CAS
CSCD
北大核心
2009年第2期139-141,共3页
Chinese Journal of New Drugs
关键词
功能性鼻内镜术
氟比洛芬酯
芬太尼
患者自控镇痛
functional endscopic sinus surgey
flurbiprofen
fentanyl
patient-controlled analgesia
