摘要
目的比较氟比洛芬酯(凯纷)与芬太尼对功能性鼻内镜手术中瑞芬太尼复合丙泊酚全静脉麻醉患者术后急性疼痛预防的有效性和安全性。方法60例患者随机分为氟比洛芬酯组(KF组,30例)与芬太尼组(F组,30例)。手术结束前20min分别静脉推注氟比洛芬酯1mg/kg、芬太尼0.1mg,比较术后早期拔管时间,镇痛起效期1h内评估血压、心率、脉搏氧饱和度(SpO2)、呼吸频率(RR)、VRS镇痛评分以及镇静评分(OAA)。结果拔管后F组RR在5min[(13.0±0.9)次/min]、10min[(13.8±0.9)次/min]、30min[(16.5±0.9)次/min]时明显低于KF组。KF组OAA值在苏醒后5min[(0.3±0.5)分vs.(0.8±0.4)分]、10min[(0.3±0.4)分vs.(0.8±0.4)分]较F组显著降低,VRS值在苏醒后30min[(0.7±0.6)vs.(1.3±0.7)]、60min[(0.8±0.6)vs.(1.4±0.6)]较F组显著降低(P<0.05)。结论氟比洛芬酯相对芬太尼对于瑞芬太尼复合丙泊酚全静脉麻醉鼻内镜术后术后急性疼痛的防治更具优势,氟比洛芬酯1mg/kg可以防治功能性鼻内镜术后急性疼痛,同时并发症较少。
Objective To compare the efficacy and safety of 2 transition strategies using flurbiprofen or fentanil for early postoperative pain relief in patients who had nasal endoscope surgery under general anesthesia with remifentanil and propofol. Methods Sixty patients were enrolled in this doubled-blind and prospective study. Patients were randomly divided to two groups （n=30 each）： Group Flurbiprofen（KF） and Group fentanyl （F）. Twenty minutes before the end of the surgery, patients were given either bolus of lmg/kg flurbiprofen or 0.ling fentanyl.The time of extubation and BP, HR SpO2,RR,VRS and OAA were evaluated and compared within an hour after anesthesia. Results A statistically significant difference in RR between the 2 groups was recorded at 5,10,30 minutes after extubation. The RR of Group F was slower.A significant decrease of OAA values at 5 and 10minutes after extubation was found in Group KF in comparison with Group F. VRS values were significantly lower in KF group at 30 and 60 minutes after awakening. Conclusions Flurbiprofen, when compared to fentanil, has more advantages in preventing and relieving immediate postoperative pain in patients undergo nasal endoscope surgery after remifentanyl-based anesthesia, 1mg/kg flurbiprofen can ＂be used for early postoperative pain relief. Meanwhile the complications in the flurbiprofen group are fewer than those of the fentanil group.
出处
《北京医学》
CAS
2009年第11期666-668,共3页
Beijing Medical Journal
