摘要
目的观察切口内持续输注氟比洛芬酯对芬太尼静脉自控镇痛的影响。方法择期全麻下行椎体融合术的成人患者60例,随机均分为三组:A组,切口内持续输注0.1%的氟比洛芬酯200ml;B组,静脉持续输注0.1%的氟比洛芬酯200ml;C组,切口内持续输注生理盐水200ml。所有患者术后均用芬太尼10μg/ml行患者静脉自控镇痛(PCIA)。记录各组患者术后1、4、12、24、48h静息时和术后4、24、48h活动时的疼痛视觉模拟评分(VAS)和芬太尼累计用量,同时观察记录术后48h内的镇静评分、恶心、呕吐发生率及切口愈合情况。结果A组术后各时点VAS明显低于B、C组,B组明显低于C组(P<0.05)。术后48h的PCIA芬太尼累计用量A组明显低于B组和C组(P<0.05)。各组间的镇静评分及恶心、呕吐发生率差异无统计学意义。结论切口内持续输注氟比洛芬酯用于椎体融合术与静脉输注相比可更显著改善术后芬太尼PCIA的效果,并减少芬太尼累计用量。
Objective To evaluate the efficacy of continuous intrawound infusion （CIWI）of flrubiprofen axetil combined with intravenous patient-controlled analgesia （PCIA） of fentanyl for postoperative analgesia. Methods Sixty adult patients, scheduled for selective lumbar spinal fusion surgery under general anesthesia were randomly assigned to three groups. All cases were given fentanyl PCIA. The patients in group A were added 48 h CIWI with flrubiprofen axetil 200 mg/200 ml via a catheter at the end of the operation, those in group B with intravenous flrubiprofen axetil 200 mg/200 ml and those in group C with CIWI with normal saline 200 ml. Pain was assessed using VAS. Fentanyl consumption of PCIA, sedation scores and nausea, vomiting were recorded at 1, 4, 12, 24, and 48 h after surgery. Results VAS scores at rest and movement were lower in group A than those in group B and C,which was lower in group B than those in group C（P〈 0. 05）. Fentanyl consumption was less in group A than that in group B or C （P〈0.05）. Conclusion CIWI of flrubiprofen axetil combined with fentanyl PCIA provides a better postoperative analgesia and reduces fentanyl consumption of PCIA.
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2009年第6期477-479,共3页
Journal of Clinical Anesthesiology
关键词
氟比洛芬酯
芬太尼
患者静脉自控镇痛
Flrubiprofen axetil
Fentanyl
Intravenous patient-controlled analgesia
