不同剂量氟比洛芬酯对剖宫产术后布托啡诺静脉镇痛效果的影响  

Efficacy of different doses of flurbiprofen axetil on post-cesarean analgesia with butorphanol

作　　者：安小虎[1] 徐韬[1] 王苑[1] 徐子锋[1] An Xiaohu;Xu Tao;Wang Yuan;Xu Zifeng(Department of Anesthesiology, International Peace Maternal and Obstetrical Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200030, China)

机构地区：[1]上海交通大学医学院附属国际和平妇幼保健院麻醉科,200030

出　　处：《国际麻醉学与复苏杂志》2019年第7期645-648,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的 探讨不同剂量氟比洛芬酯对剖宫产术后布托啡诺静脉镇痛效果的影响。 方法 300例择期行剖宫产手术的产妇,按照随机数字表法分为3组,每组100例。Ⅰ组于胎儿取出后静脉注射生理盐水10ml,术毕行布托啡诺患者自控静脉镇痛(patient controlled intravenous analgesia, PCIA);Ⅱ组、Ⅲ组分别在胎儿取出后缓慢静脉注射氟比洛芬酯50mg和100mg,再行布托啡诺PCIA,药物配方与设置同Ⅰ组。观察术后产妇VAS评分、Ramsay镇静评分和患者自控镇痛(patientcontrol analgesia, PCA)次数以及患者对镇痛效果的满意度;记录低氧血症、恶心呕吐等并发症的发生情况。 结果 所有产妇均完成了24h镇痛观察,没有产妇需要额外的镇痛治疗;与Ⅰ组比较,Ⅱ、Ⅲ组产妇术后4、8、12、24hVAS评分更低,PCA次数更少,患者满意度高(P<0.05);与Ⅱ组比较,Ⅲ组产妇术后4、8hVAS评分低,PCA次数少,患者满意度高,差异有统计学意义(P<0.05);3组产妇术后6h恶露排出量、产后泌乳开始时间差异无统计学意义(P>0.05),3组产妇的Ramsay镇静评分、低氧血症、恶心呕吐发生率比较差异无统计学意义(P>0.05)。 结论 氟比洛芬酯静脉注射能显著改善剖宫产术后布托啡诺PCIA的临床效果,不影响子宫收缩和泌乳,未发现有明显的副作用,并且100mg效果优于50mg。Objective To study the analgesic effect of different doses of flurbiprofen axetil on post-cesarean analgesia with butorphanol. Methods Three hundreds patients undergoing elective cesarean section were randomly allocated into three group by random number table (n=100). After fetus delivery, three groups were all received patient controlled intravenous analgesia (PCIA) with butorphanol 12 mg diluted by normal saline (NS) into 100 ml (background infusion 2 ml/h, patient control analgesia (PCA) 2 ml, lockout interval 15 min). After the baby was removed, 50 mg and 100 mg flurbiprofen axetil were slowly injected intravenously in group Ⅱ and group Ⅲ, respectively. The Visual Analogue Scale(VAS) scores of incision pain, Ramesay sedation score, total PCA times and the degree of satisfaction about post-operative analgesia were measured at 4, 8, 12 h and 24 h after surgery respectively. Weight of lochia 6 h after surgery and the time of milk secretion were recorded. Other side effects such as hypoxemia, nausea, vomiting including neonatal complications were also recorded. Results There were no statistical differences in demographics among three groups. The data of all patients were collected and no patient needed extra analgesia. Compared with group Ⅰ, the VAS scores and the consumption of butorphanol of 4, 8, 12, 24 h were lower in the group Ⅱ and group Ⅲ, while the degree of satisfaction was higher(P<0.05). Compared with group Ⅱ, VAS score and the consumption of butorphanol of 4, 8 h were lower in the group Ⅲ, and the satisfaction degree was higher (P<0.05). There were no statistical differences in weight of lochia, the time of milk secretion, or side effects like hypoxemia, nausea, vomiting after surgeries(P>0.05). There were no statistical differences in Ramsay sedation scores (P>0.05). Conclusions Flurbiprofen axetil could provide better analgesic effect on post-cesarean analgesia with butorphanol (100 mg was superior to 50 mg). Furthermore, it did not influence uterine contraction or the time of milk sec

关 键 词：氟比洛芬酯 布托啡诺 剖宫产术 镇痛 

分 类 号：R614[医药卫生—麻醉学]