氟比洛芬酯超前镇痛效果及其对开胸患者术后肺功能影响的评价  

Preemptive analgesia effects of flurbiprofen axetil on respiratory function in patients undergoing thoracotomy

作　　者：李艳辉[1] 韩灵[1] 王丹[2] 麻海春[1] 

机构地区：[1]吉林大学第一医院麻醉科,吉林长春130021 [2]吉林省前卫医院麻醉科,吉林长春130012

出　　处：《吉林大学学报（医学版）》2009年第3期515-518,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(0505226)

摘　　要：目的：研究氟比洛芬酯的超前镇痛效果及对开胸患者术后肺功能的影响。方法：20例ASA1～2级开胸手术患者随机分为氟比洛芬酯组（实验组，n=10）和对照组（n=10），于切皮前15min，实验组静脉滴注氟比洛芬酯5mL（50mg），对照组静脉滴注生理盐水5mL，观察两组术后4、8、12、24和48h视觉模拟评分（VAS）及不良反应发生率，记录PCA泵按压次数，计算单位时间舒芬太尼用量。测量术前及术后24和48h肺功能（FVC、FEV1、MMEF）。结果：术后4、8、12、24和48h实验组VAS均低于对照组（P〈0．05），术后单位时间舒芬太尼用量实验组明显低于对照组（P〈0．05）。术后PCA泵手动按压及有效按压次数实验组均少于对照组（P〈0．05）。术后4、8、12、24和48h两组肺功能参数均低于术前值，术后24和48h肺功能值对照组均低于实验组，但差异无显著性（P〉0．05）。术后两组恶心、呕吐等不良反应发生率差异无显著性（P〉0．05）。结论：氟比洛芬酯应用于开胸患者具有超前镇痛的作用，且术前单次应用不增加胃肠道并发症的发生率；从肺功能改善情况看，其超前镇痛效果不足以产生临床意义。Objective To study the preemptive analgesia effects of flurbiprofen axetil on respiratory function in patients undergoing thoracotomy. Methods Twenty male patients undergoing thoracotomy were devided into two groups equally with ten cases each to receive either flurbiprofen axetil 5 mL （50 mg） （experiment group） or saline 5mL （control group） 15 rain before incision. At the end of the surgery both groups received intravenous sufentanyl PCA with a loading dose of 10 g, a maintenance dose of 2 g · h^-1 , a bolus dose of 2 g and a lockout interval of 15 min. Age, weight, sex, history of general anaesthesia were recorded. Analgesia grades at 4, 8, 12, 24, and 48 h after operation were accessed and side effects （nausea and vomiting） were recorded. Total drug use, number of boluses delivered, number of boluses demanded were collected. Pulmonary function （FVC, FEV1, MMEF） was tested the day before operation, as well as at 24 and 48 h after operation. Rosults No differences between two groups were found for demographic data. There were also no clinically relevant differences between two groups with regard to side effects （P〉0.05）. Significant differences were observed in analgesia grade between two groups. Visual analogue scores （VAS） in different postoperative time points （4, 8, 12, 24 and 48h） were lower in experiment group than those in control group （P〈0.05）. Also less bolus doses were demanded and delivered in experiment group （P〈0. 05）. Respiratory function test in both groups was not as good as that before operation.24 and 48 h after operation, the respiratory function test was better in experiment group than that in control group, but there was no significant difference （P 〉 0.05）. Conclusion Flurbiprofen axetil has preemptive analgesia effects with the chosen dosage regimen in patients undergoing thoracotomy and doesn＇t increase side effects. But the preemptive analgesia can＇ t improve postoperative respiratory function.

关 键 词：超前镇痛 氟比洛芬酯 肺功能 患者自控静脉镇痛 开胸手术 

分 类 号：R614[医药卫生—麻醉学]