摘要
目的探讨切皮前及切皮后应用氟比洛芬酯对结直肠肿瘤切除术患者术后自控镇痛的效果及对舒芬太尼用量的影响。方法择期静吸复合全身麻醉下行结直肠肿瘤切除术患者40例,随机分为观察组和对照组各20例,观察组于切皮前30min静脉注射氟比洛芬酯100mg,对照组于切皮后30min静脉注射氟比洛芬酯100mg。术毕2组均行静脉自控镇痛(patient controlled intravenous analgesia,PCIA),自控镇痛所用药物均为舒芬太尼0.04μg/(kg·h)+生理盐水稀释至150mL。记录2组手术结束即刻及手术后2、4、6、24h静息视觉模拟评分(visual analogue scale,VAS)、伯格曼舒适度评分(Bruggrmann comfort scale,BCS),术后首次追加舒芬太尼时间,术后6、24h舒芬太尼消耗量,术后24h患者按压PCIA泵次数及不良反应的发生情况。结果 2组术后2、4、6、24h时VAS、BCS评分比较差异均无统计学意义(P>0.05);观察组首次追加舒芬太尼时间为(52.50±7.67)min、6及24h舒芬太尼消耗量为((24.60±6.31)、(79.32±12.72)μg)、24h患者PCIA按压次数为((6.67±2.40)次),对照组分别为(57.80±6.30)min、(28.32±4.85)μg、(88.68±14.90)μg、(8.75±2.38)次,2组比较差异均有统计学意义(P<0.05);术后24h观察组不良反应发生率(10%)与对照组(15%)比较差异无统计学意义(P>0.05)。结论行结直肠肿瘤切除术患者于切皮前30min静脉注射氟比洛芬酯100mg,复合术后舒芬太尼静脉自控镇痛可起到较好的镇痛效果,并可减少舒芬太尼用量。
Objective To investigate the effect of pre-and post-incisional administration of flurbiprofen axetil（FA）in patient-controlled intravenous analgesia（PCIA）after colorectal surgery,and its influence on sufentanil consumption.Methods Forty patients undergoing elective colorectal carcinoma resection under inhalational-intravenous general anesthesia were divided into observation group and control group,with 20 patients in each group.Observation group was intravenously injected 100 mg FA 30 minutes before skin incision,and control group was intravenously injected 100 mg FA 30 minutes after skin incision.Both two groups received postoperative PCIA with sufentanil 0.04μg/（kg·h）dilated into normal saline 150 mL.Analgesic and sedative efficacy was evaluated at the time points of 0,2,4,6and 24 hours after operation by recording visual analogue scale（VAS）,Bruggrmann comfort scale（BCS）,the time to the first PCIA trigger,the actual number to press PCIA trigger within 24 hours,the cumulative doses of SF consumption within 6and24 hours and the incidence of adverse reactions.Results VAS and BCS at the time points of 0,2,4,6and 24 hours postoperatively were not significantly different between two groups（P〉0.05）.In observation group,the time to the first PCIA trigger（（52.50±7.67）minutes）,sufentanil consumption at the time points of 6and 24 hours postoperatively（（24.60±6.31）,（79.32±12.72）μg）,and the actual number to press PCIA trigger during postoperative 24hours（（6.67±2.40）times）were significantly different from those in control group（（57.80±6.30）minutes,（28.32±4.85）μg,（88.68±14.90）μg,（8.75±2.38）times）（P〈0.05）.There was no significant difference in the incidence of adverse reactions within 24 hours postoperatively between observation group（10%）and control group（15%）（P〉0.05）.Conclusion Intravenous injection of FA 100 mg 30 minutes before incision plus postoperative PCIA with sufentanil can enhance postoperative analgesic effects
出处
《中华实用诊断与治疗杂志》
2014年第11期1127-1129,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
黑龙江省教育厅重点项目(12521z018)
关键词
结直肠肿瘤
切除术
氟比洛芬酯
舒芬太尼
镇痛
Colorectal carcinoma
resection
flurbiprofen axetil
sufentanil
analgesia
