氟比洛芬酯注射液联合盐酸利多卡因注射液对腰椎术后患者镇痛的疗效与安全性  

Analgesic effect and safety of flurbiprofen axel injection combined with lidocaine hydrochloride injection for patient after lumbar spine surgery

作　　者：张秦 张旭彤 张冉[1] 谷洁 冯艺[1] ZHANG Qin;ZHANG Xu-tong;ZHANG Ran;GU Jie;FENG Yi(Department of Anesthesiology,Peking University People's Hospital,Beijing 100044,Chirm)

机构地区：[1]北京大学人民医院麻醉科,北京100044

出　　处：《中国临床药理学杂志》2022年第1期6-9,共4页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探讨术后静脉镇痛泵中单用氟比洛芬酯注射液(凯纷)与联合利多卡因注射液用于腰椎手术术后的镇痛效果及药物不良反应发生情况。方法回顾性分析本院全身麻醉下行腰椎后路融合内固定手术患者72例。氟比洛芬酯组37例,镇痛方案为氟比洛芬酯注射液300-400 mg,注入100 mL静脉镇痛泵,2 mL·h^(-1),镇痛48 h^(-1)联合组35例,镇痛方案为氟比洛芬酯注射液300-400 mg+盐酸利多卡因注射液1 mg·kg^(-1)·h^(-1),注入200 mL静脉镇痛泵,4 mL·h^(-1),镇痛48 h^(-1)均使用静脉阿片类药物自控镇痛作为补救镇痛。比较两组术后24和48 h吗啡用量、疼痛评分(NRS)及不良反应。结果联合组可明显减少术后24和48 h吗啡用量6 mg[0-19.50]vs 3 mg[0-7.20],14 mg [3-41.00]vs 6 mg[0-15.00],降低术后48 h NRS评分1 [0-1.50]vs 0 [0-1.00]。术后24 h疼痛评分、便秘、头晕、恶心、皮肤瘙痒方面差异无统计学意义(P>0.05)。结论氟比洛芬酯注射液联合盐酸利多卡因注射液用于腰椎手术术后静脉镇痛可减少术后24和48 h的吗啡用量,降低术后48 h NRS评分,可安全用于术后镇痛。Objective To investigate the analgesic effect and adverse drug reactions of flurbiprofen axetil injection alone and combined with lidocaine injection in postoperative intravenous analgesia pump after lumbar spine surgery. Methods A retrospective analysis was performed on 72 patients undergoing lumbar posterior fusion and internal fixation under general anesthesia in our hospital, 37 patients in flurbiprofen axel group, 35 patients in combined group. The analgesic scheme was flurbiprofen axel injection 300-400 mg, injected into 100 mL intravenous analgesic pump, 2 mL per hour, for 48 h. In the combined group, 35 patients were given the analgesic regimen of flurbiprofen axel injection 300-400 mg+lidocaine hydrochloride injection 1 mg·kg^(-1)·h^(-1), injected into 200 mL intravenous analgesic pump at the dosage of 4 mL per hour for 48 h. All patients used intravenous opioid controlled analgesia as remedial analgesia. The consumption of morphine, NRS score of pain intensity and adverse reactions were compared between the two groups at 24 and 48 h postoperatively. Results The combined group could significantly reduce the consumption of morphine at 24 and 48 h after operation 6 mg [0-19. 50]vs 3 mg[0-7. 20],14 mg[3. 00-41. 00]vs 6 mg[0-15. 00],decreased NRS score 48 h after operation 1 [0-1. 50]vs 0 [0-1. 00]. There were no significant differences in pain score,constipation,dizziness,nausea and pruritus 24 h after surgery( P > 0. 05). Conclusion Flurbiprofen axel injection combined with lidocaine hydrochloride injection can reduce the dosage of morphine at 24 and 48 h and NRS score at 48 h after lumbar surgery.It can be used safely for postoperative analgesia.

关 键 词：氟比洛芬酯 利多卡因 术后镇痛 吗啡用量 

分 类 号：R614[医药卫生—麻醉学]