芬太尼和氟比洛芬酯注射液在术前准备间患者镇静镇痛中的应用  

Midazolam combined with fentanyl or flurbiprofen axetil injection in preoperative preparation room for sedation-analgesia to patients before surgery

作　　者：刘超 张小丹 许军军[1] 何苗[1] Liu Chao;Zhang Xiaodan;Xu Junjun;He Miao(Department of Anesthesiology,Peking University People's Hospital,Beijing City 100044)

机构地区：[1]北京大学人民医院麻醉科,北京100044

出　　处：《中华疼痛学杂志》2023年第6期957-961,共5页Chinese Journal Of Painology

摘　　要：目的回顾性分析芬太尼和氟比洛芬酯注射液在术前准备间患者镇静镇痛中的作用。方法收集北京大学人民医院麻醉科2019年2月至2019年10月在术前准备间接受有创动脉及中心静脉穿刺置管的患者90例,按照数字随机表法将患者分为3组(n=30)。3组患者进入准备间后分别接受咪唑安定0.02 mg/kg(C组)、咪唑安定0.02 mg/kg+芬太尼1μg/kg(F组)、咪唑安定0.02 mg/kg+氟比洛芬酯注射液1 mg/kg(FP组)静脉镇静镇痛治疗。给药后10 min麻醉科医师进行穿刺操作。记录患者在接受有创动脉穿刺置管和中心静脉穿刺置管时的疼痛数字等级评分(NRS)。记录给药前、操作前即刻(给药后10 min)以及操作结束时的脑电双频指数(BIS)和OAA/S镇静评分并观察不良反应。结果F组和FP组患者接受有创动脉穿刺置管和中心静脉穿刺置管时的NRS疼痛评分均显著低于C组。FP组患者接受有创动脉穿刺置管时的NRS评分与F组差异无统计学意义,但FP组患者接受中心静脉穿刺置管时的NRS评分显著低于F组患者。3组患者操作前即刻以及操作结束时的BIS值均显著低于BIS基础值,3组患者操作前即刻以及操作结束时的OAA/S评分与OAA/S基础值差异无统计学意义。3组患者各时点的BIS值以及OAA/S评分差异无统计学意义(P>0.05)。F组有1例窦性心动过缓和1例恶心呕吐不良反应,C组和FP组患者未见不良反应。结论对于在术前准备间接受有创动脉及中心静脉穿刺置管的患者,与采用咪唑安定和咪唑安定联合芬太尼镇静镇痛的效果相比,咪唑安定联合氟比洛芬酯注射液的镇静镇痛效果较好,不良反应发生率低。Objective To retrospectively analyze the sedation-analgesic effects of fentanyl or flurbiprofen axetil injection on patients in preoperative preparation room.Methods From February 2019 to October 2019,90 patients underwent invasive arterial and central venous catheterization during preoperative preparation room in the Department of Anesthesiology,Peking University People's Hospital,were randomly divided into three groups,group C,group F and group FP.The patients were given midazolam 0.02 mg/kg in group C,midazolam 0.02 mg/kg combined with fentanyl 1μg/kg in group F and midazolam 0.02 mg/kg combined with flurbiprofen axetil injection 1mg/kg in group FP before operation respectively.The NRS pain score during the operation of the invasive arterial and central venous catheterization were recorded.Bispectral index(BIS)and OAA/S sedation score and adverse reactions were also recorded and observed before the administration,immediately before operation(10 min after the administration)and at the end of operation.Results The NRS pain scores were significantly lower during invasive arterial and central venous catheterization in the group F and group FP than those in the group C.There was no significant difference in NRS scores between the group FP and the group F during invasive arterial catheterization.But the NRS scores was significantly lower in the group FP than that in the group F during central venous catheterization.The levels of BIS immediately before operation and at the end of operation were significantly lower than that before administration in the three groups,but there were no significant differences among the scores of OAA/S before administration,immediately before operation and at the end of operation in the three groups.There were no significant differences in the levels of BIS and OAA/S scores at different time points among the three groups.No adverse reactions occurred in the group C and FP,while 1 case of sinus bradycardia and 1 case of nausea and vomiting occurred in the group F.Conclusion Compared with

关 键 词：芬太尼 氟比洛芬 手术前镇痛 术前准备间 

分 类 号：R614[医药卫生—麻醉学]