氟比洛芬酯注射液复合芬太尼在不停跳冠脉搭桥术后的镇痛效果和安全性  

Efficacy and safety of postoperative analgesia with flurbiprofen axetil and fentanyl after off-pump coronary artery graft bypass

作　　者：王成彬[1] 赵文度[1] 卿恩明[1] 

机构地区：[1]首都医科大学附属北京安贞医院麻醉科,北京100029

出　　处：《中国新药杂志》2009年第11期1012-1015,1031,共5页Chinese Journal of New Drugs

摘　　要：目的：评价氟比洛芬酯注射液（凯纷）在不停跳冠脉搭桥手术后镇痛时联合应用芬太尼镇痛的效果和安全性。方法：择期不停跳冠脉搭桥手术患者100例，随机分为5组，每组20例，术后镇痛泵持续静脉注入镇痛液2mL·h^-1。镇痛泵配制为对照组（A组）芬太尼2mg以生理氯化钠注射液稀释至200mL，B组术前静脉注射氟比洛芬酯注射液100mg，镇痛泵中加入芬太尼2mg以生理氯化钠注射液稀释至200mL；C组镇痛泵中加入氟比洛芬酯注射液100mg＋芬太尼2mg＋0．9％生理氯化钠注射液共200mL；D组术前静脉注射氟比洛芬酯注射液100mg，镇痛泵中加入氟比洛芬酯注射液100mg＋芬太尼2mg＋0．9％生理氯化钠注射液至200mL；E组术前静脉注射氟比洛芬酯注射液100mg，镇痛泵中加入氟比洛芬酯注射液200mg＋芬太尼1mg＋0．9％生理氯化钠注射液至200mL。观察并记录各组术后镇痛评分（VAS评分）、镇痛效果、阿片类药物补充次数、不良反应。结果：术前静注氟比洛芬酯注射液和镇痛泵中添加氟比洛芬酯注射液者能明显改善手术后24～48h的镇痛效果，而且较大剂量氟比洛芬酯注射液并未增加恶心呕吐的发生率，镇痛期间未见严重不良反应。结论：氟比洛芬酯注射液可以安全有效地应用于不停跳冠脉搭桥术后镇痛，效果优于单纯应用芬太尼镇痛。Objective： To assess the efficacy and safety of postoperative analgesia with intravenous flurbiprofen axetil and fentanyl after off-pump coronary artery graft bypass. Methods： One hundred patients were randomly allocated to 5 groups （n = 20 for each group）. The patients were treated with one of the following regimens ： （A） postoperative fentanyl 2 mg in 200 mL 0.9% NaCl; （B） preoperative flurbiprofen axetil 100 mg and postoperative fentanyl 2 mg in 200 mL 0.9% NaCl; （C） postoperative flurbiprofen axetil 100 mg＋ fentanyl 2 mg in 200 mL 0.9% NaC1; （D） preoperative flurbiprofen axetil 100 mg and postoperative flurbiprofen axetil 100 mg＋ fentanyl 2 mg in 200 mL 0.9% NaCl; （E） preoperative flurblprofen axetil 100 mg and postoperative flurbiprofen axetil 200 mg＋ fentanyl 1 mg in 200 mL 0.9% NaCl. Pain scores at rest and adverse effects were recorded. Results： No significant differences were found in the age, body mass index and operative duration among the five groups. At 24 to 48 h after surgery, the VAS in patients treated with additional flurbiprofen axetil （regimens B, D, E） was significantly lower than in patients without flurbiprofen axetil （regimen A）. There were no significant differences in VAS between patients with regimans A/C and the other groups at various time points. The incidence of nausea was higher in patients with preoperative and postoperative flurbiprofen （regimen D） than in other 3 flurbiprofen groups. Conclusion ： Peri-operative analgesia with addition of flurbiprofen axetil to fentanyl has more perfect analgesic effect and low adverse effects than with fentanyl alone.

关 键 词：氟比洛芬酯注射液 芬太尼 术后镇痛 不停跳冠脉搭桥术 

分 类 号：R971.2[医药卫生—药品]