氟比洛芬酯超前镇痛对重度阻塞性睡眠呼吸暂停综合征患者术后疼痛及炎症反应的影响  

Effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammatory response in patients with severe obstructive sleep apnea syndrome

作　　者：李静阳 郭新玲[1] 刘勤楠 郭自伟 王哲 王灏 刘和平[1] LI Jingyang;GUO Xinling;LIU Qinnan;GUO Ziwei;WANG Zhe;WANG Hao;LIU Heping(Department of Anesthesiology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院麻醉科,河南新乡453003

出　　处：《新乡医学院学报》2020年第6期540-543,共4页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020383);河南省卫生科技创新型人才“51282”工程。

摘　　要：目的探讨氟比洛芬酯超前镇痛对重度阻塞性睡眠呼吸暂停综合征(OSAHS)患者术后疼痛及炎症反应的影响。方法选择2018年10月至2019年4月于新乡医学院第三附属医院择期行悬雍垂腭咽成形术的OSAHS患者60例为研究对象,按手术单、双日将患者分为对照组与观察组,每组30例。观察组患者麻醉前缓慢静脉推注氟比洛芬酯50 mg,对照组患者给予生理盐水5 mL;2组患者均采用全凭静脉麻醉诱导及维持。观察2组患者术前(T0)和术后24 h(T5)时平均动脉压(MAP)和心率(HR)的变化,采用视觉模拟评分法(VAS)评估2组患者拔管时(T1)、术后1 h(T2)、术后6 h(T3)、术后12 h(T4)、术后24 h(T5)时的疼痛程度,记录2组患者术后24 h内有效按压镇痛泵的次数,采用酶联免疫吸附试验法检测2组患者T0及T5时血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平,比较2组患者术后不良反应发生情况。结果 2组患者T0时HR、MAP比较差异无统计学意义(P>0.05);2组患者T5时HR、MAP低于T0时,且观察组患者T5时HR、MAP低于对照组(P<0.05)。观察组患者T1、T2、T3、T4、T5时VAS评分低于对照组(P<0.05)。观察组患者24 h内有效按压镇痛泵次数少于对照组(P<0.05)。2组患者T0时血清hs-CRP、TNF-α和IL-6水平比较差异无统计学意义(P>0.05)。2组患者T5时血清hs-CRP、TNF-α和IL-6水平均高于T0(P<0.05)。观察组患者术T5时血清hs-CRP、TNF-α和IL-6水平低于对照组(P<0.05)。观察组和对照组患者术后不良反应发生率分别为13.3%(4/30)和43.3%(13/30);观察组患者术后不良反应发生率低于对照组(χ^2=6.648,P<0.05)。结论氟比洛芬酯超前镇痛能有效减轻OSAHS患者术后疼痛程度,减少炎症细胞因子的生成与释放。Objective To investigate the effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammatory response in patients with severe obstructive sleep apnea syndrome(OSAHS).Methods A total of 60 OSAHS patients who underwent uvulopalatopharyngoplasty in the Third Affiliated Hospital of Xinxiang Medical University from October 2018 to April 2019 were selected as the study objects.The patients were divided into control group and observation group according to single or dual day of operation,with 30 patients in each group.Patients in the observation group were given flurbiprofen axetil 50 mg by slow intravenous infusion before anesthesia,and patients in the control group were given 5 mL normal saline,and all patients were induced and maintained by intravenous anesthesia.The changes of mean arterial pressure(MAP)and heart rate(HR)before operation(T 0)and at 24 hours(T 5)after operation in the two groups were observed.The pain of patients in the two groups during extubation(T 1),at 1 hour after operation(T 2),at 6 hours after operation(T 3),at 12 hours after operation(T 4),and at 24 hours after operation(T 5)was assessed by visual analogue scale(VAS)and the number of effective pressure on the analgesic pump was recorded within 24 hours after surgery.The serum levels of hypersensitive C reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)were measured by enzyme-linked immunosorbent assay at T 0 and T 5.And the incidence of postoperative adverse reactions in the two groups was compared.Results There was no significant difference in the HR and MAP at T 0 between the two groups(P>0.05).The HR and MAP in the two groups at T 5 was lower than that at T 0,and but the HR and MAP in the observation group was lower than that in the control group at T 5(P<0.05).The VAS score in the observation group was lower than that in the control group at T 1,T 2,T 3,T 4 and T 5(P<0.05).The number of effective compression analgesia pump in the observation group was less than that in the contr

关 键 词：氟比洛芬酯 超前镇痛 重度阻塞性睡眠呼吸暂停综合征 疼痛 炎症反应 

分 类 号：R971.2[医药卫生—药品]