氟比洛芬酯复合舒芬太尼术后镇痛效果及抗炎作用的研究  

The effects of continuous infusion of flurbiprofen combined with sufentanil on postoperative analgesia and anti-inflammatory

作　　者：王戡[1] 潘芳[1] 冯艺[1] 杨拔贤[1] 

机构地区：[1]北京大学人民医院麻醉科,100044

出　　处：《临床麻醉学杂志》2011年第10期941-943,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察不同剂量的氟比洛芬酯(FP)注射液复合舒芬太尼行术后镇痛的效果及其对炎性反应的影响。方法选择112例行腰椎间盘减压融合术、胸腔镜肺叶切除术患者,随机分为FP 1组(F1组)30例、FP 2组(F2组)31例、FP 3组(F3组)25例和对照组(C组)26例。术后镇痛泵均采用双泵设置,泵1:F1、F2、F3组分别为舒芬太尼100μg+FP 1、2、3 mg.kg-1.d-1+生理盐水至100 ml;C组舒芬太尼100μg+生理盐水至100 ml,恒速泵注2 ml/h。泵2(补救镇痛,PCA输注):四组均为舒芬太尼100μg+生理盐水至100 ml,2 ml/15 min。F1、F2、F3组患者手术开始前5 min均给予FP 1 mg/kg。记录给药后24、48 h VAS评分、PCA按压次数。于给药前、给药后6、24、48 h抽取静脉血测定血清肿瘤坏死因子α(TNF-α)、白细胞介素-6(IL-6)浓度;F1、F2、F3组给药后6、24、48 h FP血药浓度。结果给药后24 h C组VAS评分高于F2、F3组,F1组高于F3组(P<0.05);给药后48 h C组VAS评分高于F2及F3组(P<0.05)。给药后48 h F1组PCA按压次数多于F3组(P<0.05)。给药后24 h C组ΔTNF-α高于F2、F3组(P<0.05),给药后48 h C组ΔTNF-α高于F2组(P<0.05)。给药后6、24、48 h F1、F2组FP血药浓度均低于F3组(P<0.05)。结论围手术期使用FP可明显改善患者的术后疼痛,降低VAS评分和TNFα-水平。术后静脉镇痛泵中采用舒芬太尼1μg/ml复合FP 2 mg.kg-1.d-1可以达到较为满意的镇痛效果。Objective To investigate the effects of flurbiprofen（FP） combined with sufentanil on postoperative analgesia and anti-inflammatory. Methods One hundred and twelve patients （ASA Ⅰ or Ⅱ, aged 30-70 years old）, scheduled for lumbar disc decompression operation and VATS lobectomy under general anesthesia. All patients were randomly divided into four groups. Control group （group C）, the other three groups were given flurbiprofen （1 mg/kg） 5 min before surgery. Pump 1 sufentanil 100 μg＋different concentration FP （group C：0 and F1,F2,F3：1,2,3 mg·kg^-1·d^-1 respectively） ＋normal saline to 100 ml, base：2 ml/h;pump 2 sufentanil 100 μg＋normal saline to 100 ml,PCA：2 ml/15 min. The scores of VAS and the times of requirement for PCA were recorded at 6, 24 and 48 h after surgeries. The serum TNF-α, IL-6 concentration and plasma concentration of flurbiprofen were measured before flurbiprofen administration, 6, 24 and 48 h after administration. Results The scores of VAS in group C were higher than that in group F2 and F3, and that in group F1 were higher than group F3 in 24 h（P〈0. 05）; the scores of VAS in group C were higher than that in group F2 and F3 in 48 h（P〈0. 05）. The times of PCA in group F1 were more than in group F3（P〈0. 05）in 48 h. The value of TNF-α in group C was higher than that in group F2 and F3（P〈0. 05）in 24 and 48 h. Plasma concentration of flurbiprofen was higher in group F1 and in group F3（P〈0. 05）,and group F2 was higher than that in group F3（P〈0. 05）at 6,24,48 h. Conclusion Perioperative using of flurbiprofen.could attenuate the pain of patients, lower VAS score and decrease TNF-α levels. Postoperative intravenous analgesia with sufentanil 1 μg/ml combinded with flurbiprofen 2 mg·kg^-1·d^-1 can achieve satisfactory of analgesia.

关 键 词：氟比洛芬酯 多模式镇痛 炎性反应 

分 类 号：R614[医药卫生—麻醉学]