臂丛神经阻滞下地佐辛联合氟比洛芬酯对上肢骨科手术患者单一地佐辛静脉PCA效应的影响  

Effect of intraoperative dezocine combined with flurbiprofen axetil on PCA outcome with single use of intravenous dezocine in patients following upper-limb orthopedic surgery under brachial plexus block

作　　者：江琦 杨进辉 吴宝华 陈宇 张思甜 辛典 周丽华 Jiang Qi;Yang Jinhui;Wu Baohua;Chen Yu;Zhang Sitian;Xin Dian;Zhou Lihua(Department of Anesthesiology,Guangzhou Orthopedics Hospital,Guangzhou 510045,China)

机构地区：[1]广州市正骨医院麻醉科,广东广州510045

出　　处：《广州医科大学学报》2021年第4期44-46,共3页Academic Journal of Guangzhou Medical University

摘　　要：目的:探讨臂丛神经阻滞下地佐辛联合氟比洛芬酯对骨科上肢手术患者单一地佐辛静脉PCA效应的影响。方法:选取广州市正骨医院麻醉科2019年4-8月收治的上肢骨科手术患者60例作为研究对象,根据随机数字表法分为地佐辛联合氟比洛芬酯组(DF组)和氟比洛芬酯组(F组),每组各30例。DF组在手术结束前15 min缓慢静注地佐辛2 mg+氟比洛芬酯50 mg,F组则在手术结束前15 min缓慢静注氟比洛芬酯50 mg,两组均配单一地佐辛静脉镇痛泵以地佐辛40 mg稀释至100 ml生理盐水,静脉镇痛泵设置背景剂量2.0 ml/h,冲击剂量2.0 ml,锁定时间20 min,镇痛48 h。观察并记录两组术后2(T_(1))、4(T_(2))、6(T_(3))、12(T_(4))、24 h(T 5)静息疼痛强度(VAS),术后4(T_(2))、6(T_(3))、12 h(T_(4))PCA总按压次数、有效按压次数、不良反应。结果:DF组T_(2)、T_(3)时点静息VAS评分均低于F组(P<0.05),DF组T_(2)、T_(3)、T_(4)时点PCA有效按压次数和总按压次数均低于F组(P<0.01)。DF组出现1例头晕、1例尿潴留,F组出现1例尿潴留。结论:臂丛神经阻滞下单次小剂量地佐辛联合氟比洛芬酯可有效减轻上肢骨科手术后早期疼痛。Objective:To investigate the effect of intraoperative dezocine combined with flurbiprofen axetil on PCA outcome with single use of intravenous dezocine in patients following upper-limb orthopedic surgery under brachial plexus block.Methods:A total of 60 patients scheduled for upper-limb orthopedic surgery and registered to Department of Anesthesiology,Guangzhou Orthopedics Hospital between April and August 2019,were enrolled as study subjects.According to random number table,they were divided into dezocine combined with flurbiprofen axetil group(group DF)and flurbiprofen axetil group(group F)(n=30 each).The group DF was given a slow intravenous injection of 2 mg dezocine+50 mg flurbiprofen axetil,while the group F was given a slow intravenous injection of flurbiprofen axetil 50 mg alone,at 15 min prior to the end of surgery.After surgery,the both groups were given intravenous analgesic pump with single use of 40 mg dezocine diluted to 100 ml of normal saline.The intravenous analgesic pump was set to achieve a background dose of 2.0 ml/h,a bolus dose of 2.0 ml,and a lockout time of 20 min,for 48h analgesia.The two groups were observed and recorded for severity of pain at rest(VAS)at hours 2(T_(1)),4(T_(2)),6(T_(3)),12(T_(4)),and 24(T 5)after operation,the total and valid pressings of the PCA pump at T_(2),T_(3)and T_(4),as well as adverse reactions.Results:The VAS scores at rest at T_(2)and T_(3)in the group DF were lower than those in the group F(P<0.05).The valid and total PCA pressing at T_(2),T_(3)and T_(4)in the group DF were fewer than those in the group F(P<0.01).One each from the patients in group DF developed dizziness and urinary retention,and one from group F developed urinary retention.Conclusion:Single use of low-dose dezocine combined with flurbiprofen axetil under brachial plexus block can effectively reduce the pain early after upper limb orthopedic surgery.

关 键 词：地佐辛 氟比洛芬酯 骨科 上肢 

分 类 号：R614.24[医药卫生—麻醉学]