超前镇痛用于颌面外科围术期镇痛60例临床研究  

Clinic study effects of preemptive analgesia efficacy in perioperation analgesia of maxillofacial surgery

作　　者：刘颖[1] 刘西娟[1] 杨菊花[1] 王智[1] 张淼[1] 

机构地区：[1]西安交通大学口腔医院麻醉科,西安710004

出　　处：《陕西医学杂志》2010年第11期1469-1471,共3页Shaanxi Medical Journal

基　　金：陕西省科学技术研究发展计划项目基金资助(2010K15-08)

摘　　要：目的：观察氟比洛芬酯用于口腔颌面外科手术超前镇痛的作用效果。方法：将60例ASA-级行口腔颌面外科手术的患者随机分为空白对照（对照组）、全麻诱导前静脉缓注氟比洛芬酯1 mg/kg（观察1组）、全麻诱导前及术后6 h分别静脉缓注氟比洛芬酯1 mg/kg（观察2组）三组,每组20例。三组均行静脉全身麻醉,术毕三组开启同样配方的患者静脉自控镇痛（PCIA）泵。分别记录术后1、4、6、12、24h的视觉模拟评分（VAS）,PCIA泵的按压次数和不良反应。并在镇痛结束后统计患者对镇痛治疗的总体满意度。结果：VAS评分在术后6h以内观察1、2组显著低于对照组;术后6-12 h观察2组显著低于观察1组和对照组。术后PCIA泵按压次数观察1组显著低于对照组,而观察2组显著低于观察1组。镇痛结束后,观察1、2组患者对镇痛治疗总体满意度明显好于对照组。结论：诱导前及术后6 h追加氟比洛芬酯用于颌面外科围术期镇痛,能减少术后的芬太尼用量,并提高镇痛质量。Objective：To observe the Preemptive analgesic effect of flurbiprofen axetil used at perioperation analgesia in patients undergoing maxillofacial surgery.Methods ：Totally 60 maxillofacial patients undergoing surgery under general anesthesia were divided into three groups randomly： group 1（n=20） was control group;group 2（n=20） was given 1 mg/kg flurbiprofen axetil intravenously prior to the induction of general anesthesia;and group 3（n=20） was injected intravenously with 1 mg/kg flurbiprofen axetil on prior to the induction of general anesthesia and 6 h after the surgery.All the three groups received the same patients controlled intravenous analgesia（PCIA,containing fentanyl 1 mg,diluted to 100 ml,2 ml/ h） at the end of surgery.VAS pain score was recorded at the time of at 1,4,6,12 and 24 h after surgery.The times of PCIA button press were recorded at the end of operation to 24 h and 24 to 48 h after surgery.Results：VAS scores of group 2 and 3 were also significantly lower than those in group 1 at the time of at 1,4,6 h after the surgery,and those in the group 3 were significantly lower than those in the group 26 h after the surgery.Compared to group 1,the times of PCIA button press were significantly less in those of group 2,while those of group 3 were less than those in group 2; The overall satisfaction to analgesic therapy in group 2 and 3 were more than that in group 1 in grade Ⅰ～II.Conclusion：Useing Flurbiprofen axetil before induction combined with 6 h after operation can produce preemptive effect,save the requirements of fentanyl.

关 键 词：镇痛 病人控制 麻醉 静脉 氟比洛芬/治疗应用 口腔外科手术 手术期间 

分 类 号：R782[医药卫生—口腔医学]