氟比洛芬酯抑制瑞芬太尼致患者术后痛觉过敏的药效学研究  

Dose-response relationship of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia

作　　者：叶柏波[1] 刘德昭[1] 沈宁[1] 

机构地区：[1]中山大学附属第三医院麻醉科,广州518630

出　　处：《中华普通外科学文献（电子版）》2011年第4期17-19,共3页Chinese Archives of General Surgery(Electronic Edition)

基　　金：广东省医学科学基金资助(A2010175)

摘　　要：目的探讨氟比洛芬酯(凯芬)抑制瑞芬太尼致患者术后痛觉过敏反应的量效关系。方法选择我院2010年1至6月期间,择期全麻下腹部大手术患者50例,静脉注射咪达唑仑、芬太尼、丙泊酚和顺阿曲库铵麻醉诱导后,气管插管后行静脉麻醉。术中静脉输注0.25μg·kg-1·min-1瑞芬太尼和3～4mg·kg-1·h-1丙泊酚,间断静脉注射顺阿曲库铵维持麻醉。麻醉诱导后,采用序贯法静脉注射氟比洛芬酯,初始剂量为1mg/kg,相邻梯度为0.2mg/kg。采用概率单位分析法计算氟比洛芬酯抑制瑞芬太尼术后痛觉过敏的量效关系:半数有效剂量(ED50)、95%有效剂量(ED95)及其95%可信区间。结果氟比洛芬酯抑制瑞芬太尼致患者术后痛觉过敏的ED50为1.40(95%CI=1.13～1.61)mg/kg,ED95为2.21(95%CI=1.89～3.33)mg/kg。结论氟比洛芬酯抑制瑞芬太尼致术后痛觉过敏的ED50和ED95分别为1.40mg/kg和2.21mg/kg。Objective To investigate the dose-response relationship of flurbiprofen for inhibiting post- operative hyperalgesia after remifentanil-based anesthesia in patients undergoing major abdominal surgery. Methods Fifty patients undergoing major abdominal surgery under remifentanil-based general anesthesia were studied. Anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 4 μ g/kg and cisatracurium 1 mg/kg and maintained with infusion of remifentail （0.25 μ g·kg^-1·min^-1） and propofol （3-4 mg·kg^-1·h^-1）. Cisatracurium was given intermittently. The patients were mechanically ventilated after tracheal intubation. Flurbiprofen was given before skin incision for inhibiting remifentanil-induced postoperative hyperalgesia. Pain was assessed using VAS at 10 min after tracheal extubation. VAS score 〈4 was defined as effective. The optimal dose was determined by Dixon＇s up-and-down method. If the VAS score was 〈4, the next patient received a lower dose of flurbiprofen, or conversely if ineffective, a high dose was given in the next patient. The up-and-down sequences were analyzed by using probit method that determine the ED50, ED95 and 95% confidence interval （CI）. Results The ED50 and ED95 of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia in patients following gynecological laparoscopy were 1.40（95% CI=1. 13- 1.61）mg/kg and 2.21（95% CI=1.89-3.33）mg/kg. Conclusion The ED50 and ED95 of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia in patients following major abdominal surgery are 1.40 mg/kg and 2.21 mg/kg respectively.

关 键 词：氟比洛芬酯 瑞芬太尼 痛觉过敏 量效关系 

分 类 号：R614[医药卫生—麻醉学]