氟比洛芬酯超前镇痛对功能性鼻内镜鼻窦手术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 inflammation in patients undergoing functional endoscopic sinus surgery

作　　者：郭新玲[1] 李静阳 刘勤楠 王琳 王哲 刘桂平[2] 刘和平[1] GUO Xinling;LI Jingyang;LIU Qinnan;WANG Lin;WANG Zhe;LIU Guiping;LIU Heping(Department of Anesthesiology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,HenanProvince,China;Department of Public Health,the Third Affiliated Hospital of Xinxiang MedicalUniversity,Xinxiang453003,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 [2]新乡医学院第三附属医院公共卫生科,河南新乡453003

出　　处：《新乡医学院学报》2021年第1期52-56,共5页Journal of Xinxiang Medical University

基　　金：2018年河南省医学科技攻关计划联合共建项目(编号:2018020383)。

摘　　要：目的观察氟比洛芬酯超前镇痛对功能性鼻内镜鼻窦手术(FESS)患者术后疼痛及炎症反应的影响。方法选择2019年2月至2020年2月于新乡医学院第三附属医院择期行全身麻醉下FESS的60例慢性鼻窦炎患者为研究对象,按手术日期的单、双日分为观察组与对照组,每组30例。观察组患者在麻醉诱导前缓慢静脉推注氟比洛芬酯50mg,对照组患者在麻醉诱导前给予9g·L^-1氯化钠注射液5mL。2组患者均给予咪达唑仑0.05mg·kg^-1、舒芬太尼0.4μg·kg^-1、丙泊酚2.0mg·kg^-1、苯磺酸顺阿曲库铵0.15mg·kg^-1进行麻醉诱导。比较2组患者拔管时及术后1、6、24、48h的心率(HR)和平均动脉压(MAP),采用视觉模拟评分法(VAS)评估患者疼痛情况;记录2组患者术后48h内镇痛泵的有效按压次数;比较2组患者拔管时、拔管后1min和5min躁动评分(RS)。采用酶联免疫吸附试验法检测2组患者术前及术后24、48h血清中超敏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组患者拔管时HR及MAP显著高于术后1、6、24、48h(P<0.05);2组患者术后1、6、24、48h之间HR及MAP比较差异无统计学意义(P>0.05)。拔管时及术后1、6、24、48h,观察组患者HR及MAP显著低于对照组(P<0.05)。拔管时观察组患者VAS评分与对照组比较差异无统计学意义(P>0.05);术后1、6、24、48h,观察组患者VAS评分显著低于对照组(P<0.05)。2组患者拔管时VAS评分显著低于术后1、6、24、48h(P<0.05);观察组患者术后1、6、24、48h之间VAS评分比较差异无统计学意义(P>0.05);对照组患者术后1hVAS评分显著低于术后6、24、48h(P<0.05);对照组患者术后6、24、48h之间VAS评分比较差异无统计学意义(P>0.05)。观察组术后48h内镇痛泵的有效按压次数显著低于对照组(P<0.05)。拔管时及拔管后1,5min,观察组患者RS评分显著低于对照组(P<0.05);2组患者�Objective To observe the effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammation in patients underwent functional endoscopic sinus surgery(FESS).Methods A total of 60 patients who underwent FESS under general anesthesia in the Third Affiliated Hospital of Xinxiang Medical University from February 2019 to February 2020 were selected as study subjects,and they were divided into the observation group and control group according to the operation date,with 30 patients in each group.The patients in the observation group were injected intravenously 50 mg of flurbiprofen axetilslowly before anesthesia,and the patients in the control group were injected 5 m L of 9 g·L^-1 sodium chloride.All patients were induced by intravenous anesthesia with miduzolam 0.05 mg·kg^-1,sufentanil 0.4μg·kg^-1,propofol2.0 mg·kg^-1,cisatracurium besylate 0.15 mg·kg^-1.The changes of mean arterial pressure(MAP),heart rate(HR)of the patients were compared between the two groups at the time points of extubation and 1,6,24,48 h after operation.The pain of all patients were evaluated by visual analogue scale(VAS).The effective press numbers of analgesia pump within 48 h were recorded.Restlessness scores(RS)of patients were compared between the two groups at the time paints of extubation and 1,5 min after extubation.The levels of serum hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)of patients in the two groups were analyzed by enzyme linked immunosorbent assay before operation and24,48 h after operation.The postoperative adverse reactions of patients were observed and compared between the two groups.Results The HR and MAP of patients in the two groups at the time point of extubation were significantly higher than those at1,6,24,48 h after operation(P<0.05).There was no significant difference in the HR and MAP of patients between the time points at 1,6,24,48 h after operation in the two groups(P>0.05).The HR and MAP of patients in the observation group were

关 键 词：氟比洛芬酯 超前镇痛 功能性鼻内镜鼻窦手术 疼痛 炎症反应 

分 类 号：R614[医药卫生—麻醉学]