两种非甾体抗炎药物在隆乳术后镇痛中的应用  

Application of intravenous NSAIDs for postoperative analgesia after augmentation mammaplasty

作　　者：孙焱芫[1] 于晓荣[2] 刘晓华[1] 张巧梅[1] 董海龙[1] 

机构地区：[1]第四军医大学附属西京医院麻醉科,陕西西安710032 [2]西安市第四医院麻醉科

出　　处：《中国美容医学》2011年第4期543-545,共3页Chinese Journal of Aesthetic Medicine

基　　金：国家自然科学基金面上资助项目(编号:30872434)

摘　　要：目的:观察静脉注射帕瑞昔布钠、氟比洛酚酯用于隆乳术后镇痛的效果,探讨常用非甾体抗炎药物的临床应用。方法:门诊或术后短期留院观察行硅胶假体隆乳手术患者80例,ASA I～II级。经喉罩吸入七氟醚复合小剂量芬太尼全麻术后,要求镇痛的患者随机分为芬太尼自控镇痛(F)组、静脉注射帕瑞昔布钠40mg(P)组和凯酚100mg(K)组,拒绝实施术后镇痛的患者作为对照(C)组。观察并记录患者术后恢复室留置时间,24 h内数字疼痛评分及不良反应的发生情况。结果:四组患者在恢复室的留置时间无统计学差异;P组和K组患者术后即刻和6h疼痛评分明显低于对照组,与F组比较24 h内均无统计学差异,镇痛疗效依次为:F组>P组>K组>C组;患者总体不良反应发生率依次为:P组<K组<C组<F组。结论:单次静脉注射帕瑞昔布钠40 mg和氟比洛酚酯100mg疗效确切,副作用少,可为门诊隆乳手术患者提供简便、安全、有效的术后镇痛。Objective To observe the efficacy and significance of intravenous parecoxib sodium and flurbiprofen for pain relief following cosmetic surgery.Methods 80 ASA I or II patients undergoing breast augmentation were selected into control group（n=20） and analgesic group（n=60） according to individual needs.The analgesic patients were randomly allocated to three treatment groups： Group F（n=20） received IV PCA with fentanyal（0.3 g kg hr-1）.The PCA pump was set up to deliver a bolus dose of fentanyal 0.1 g/kg（lockout interval 10 min）;Group P（n=20） and Group K（n=20） received IV parecoxib sodium 40 mg and flurbiprofen 100 mg respectively 20 min before the end of surgery.Time in the recovery room,pain scores,the need for rescue analgesics and side effects were recorded in the postoperative period.Follow-up evaluations were performed at 0,6 and 24h after surgery.Results The 4 groups were comparable with respect to age,body weight,height,operative time,or time in the recovery room.The numbers of unsatisfied demand were significantly higher in group C.The effect of analgesia was the best in group F,followed by group P and group K.The NRS scale scores of pain was significantly less in group P and K than in group C at 0 and 6 h after operation（P 0.05）,but compared with group F,the difference was not statistically significant within 24 h.The incidence of side reaction in group F,dizziness,nausea,vomiting and so on,were higher than in other three group.Conclusion A single dose of parecoxib sodium（40mg） and flurbiprofen（100mg） can decreased postoperative pain and side effects,and facilitated the patient satisfaction with pain management and quality of recovery after breast augmentation.

关 键 词：非甾体抗炎药 帕瑞昔布钠 氟比洛酚酯 术后镇痛 隆乳术 门诊手术 

分 类 号：R655.8[医药卫生—外科学]