地塞米松对氟比洛芬酯超前镇痛的影响  

Effect of dexamethasone on preemptive analgesia of flurbiprofen axetil

作　　者：冯翠[1] 杨春华 刘晓鸣[1] 李军[1] 高大鹏[1] 戚思华[1] 

机构地区：[1]哈尔滨医科大学第四临床医学院麻醉科,黑龙江哈尔滨150001 [2]黑龙江省武警医院麻醉科,黑龙江哈尔滨150010

出　　处：《哈尔滨医科大学学报》2010年第4期369-371,377,共4页Journal of Harbin Medical University

摘　　要：目的探讨地塞米松复合氟比洛芬酯超前镇痛对术后疼痛的影响。方法 60例择期妇科手术,随机双盲分成地塞米松10 mg复合氟比洛芬酯100 mg组(Ⅰ组)、氟比洛芬酯组100 mg组(Ⅱ组)、芬太尼50μg复合氟比洛芬酯组100 mg(Ⅲ组)。所有患者均接受L_2、L_3腰-硬联合阻滞。所有药物按分组于手术结束前15 min一次性静脉注入,观察术后6、12、24、48、72 h的VAS评分、Ramsay镇静评分及不良反应。结果术后各个时间点,Ⅰ组的VAS评分都低于Ⅱ组和Ⅲ组(P<0.05);Ⅰ组术后24 h的VAS评分高于其他各个时点(P<0.05);Ⅱ组和Ⅲ组术后48 h和72 h的VAS评分低于24 h(P<0.05)。3组组间Ramsay评分比较差异无统计学意义(P>0.05)。Ⅱ组和Ⅲ组追加镇痛药的次数高于Ⅰ组(P<0.05)。Ⅲ组恶心及皮肤瘙痒的发生率高于Ⅰ组和Ⅱ组(P<0.05)。结论地塞米松能够协同氟比洛芬酯镇痛作用,延长术后镇痛时间,副作用小,是良好的超前镇痛方法。Objective To investigate preemptive analgesia effect of dexamethasone combined with flurbiprofen axetil on postoperative pain. Methods Sixty patients undergoing selective gynecological operation were randomly divided into 3 groups： （ Ⅰ ）dexamethasone 10 mg combined with flurbiprofen axetil 100 mg; （ Ⅱ ） flurbiprofen axetil 100 mg; （ Ⅲ ） fentanyl 50 p,g combined with flurbiprofen axetil 100 mg. All patients were to receive L2-3 puncture for subarachnoid block combined epidural anesthesia. All medicine in every group were infused intravenously before 15 min of the operation was ended. Visual analgesia scale（VAS） , Rasmay scale and side effects were recorded at 6 h, 12 h ,24 h ,48 h and 72 h after operation. Results VAS in group Ⅰ were lower than those in group Ⅱ and Ⅲ at each time point （ P 〈 0.05 ） ; VAS in group Ⅰ at 24 h were higher than all other time points （ P 〈 0.05 ） ; VAS in group Ⅱand Ⅲ at 48, 72 h were lower than those at 24 h （ P 〈 0.05 ） ; There was no difference of Ramsay scores between groups （P 〉 0.05 ）. The numbers of additional analgesics in group Ⅱ and Ⅱ were higher than those in group Ⅰ （P 〈 0.05）. The incidence of nausea and skin itching in group Ⅲ were higher than those in group Ⅰ and Ⅱ （ P 〈 0.05 ）. Conclusion Dexamethasone may have synergistic analgesia effect when combined with flurbiprofen axetil, and extends the time of postoperative analgesia and reduce the adverse effect, is a good method of preemptive analgesia.

关 键 词：地塞米松 氟比洛芬酯 芬太尼 超前镇痛 静脉 

分 类 号：R971.3[医药卫生—药品]