摘要
目的:评价氟比洛芬酯预先给药防治瑞芬太尼麻醉后痛觉过敏的有效性和安全性。方法:80名行妇科腔镜手术的患者被随机分成四组,每组20例:组Ⅰ术中瑞芬太尼0.1μg.kg-1.min-1(小剂量RF组);组Ⅱ术中瑞芬太尼0.4μg.kg-1.min-1(大剂量RF组);组Ⅲ麻醉诱导前静脉注射氟比洛芬酯1.5mg/kg,术中瑞芬太尼0.1μg.kg-1.min-1(小剂量RF+F组);组Ⅳ麻醉诱导前静脉注射氟比洛芬酯1mg/kg,术中瑞芬太尼0.4μg.kg-1.min-1(大剂量RF+F组)。比较四组患者自主呼吸、意识恢复时间和拔管时间以及患者恢复期的疼痛程度和拔管后需要追加芬太尼的次数。结果:四组患者自主呼吸恢复时间、意识恢复时间和拔管时间差异无统计学意义(P>0.05)。大剂量瑞芬组苏醒后疼痛较剧烈,追加芬太尼的次数明显多于小剂量瑞芬组(P<0.05)。而应用氟比洛芬酯后,相对应组别的疼痛评分下降,追加芬太尼的总次数也相应减少。结论:术中应用大剂量瑞芬太尼会诱发术后痛觉过敏,非甾体抗炎药氟比洛芬酯一定程度上能防治这种痛觉过敏,而且不影响患者的复苏。
AIM：To evaluate the efficacy and safety of flurbiprofen axetil pretreatment in pre- venting post-anesthetic hyperalgesia induced by remifentanil. METHODS. 80 patients scheduled for gynecological laproseopic surgery were recruited and randomly allocated into four groups, each group had 20 cases. In group Ⅰ （small dose RF group）, remifentanil was administered 0. 1 μg·kg-1·min-1 during operation. In group Ⅱ （large dose RE group）, remifentanil was admin- istered 0. 4μg·kg-1·min-1 during operation. While in group Ⅲ （small dose RF ＋F group） flurbiprofen axetil 1. 5 mg/kg was injected before induction of anesthesia, remifentanil was administered 0. 1 μg·kg-1·min-1 periopera- tively, in group 1V （large dose RF＋F group） {lurbiprofen axetil 1 mg/kg was injected before induction of anesthesia, and remifentanil was ad- ministered 0.4 μg·kg-1·min-1 perioperative- ly. Time of spontaneous respiration, recovery of consciousness and endotracheal extubation were recorded. Pain levels during post anesthetic recovery period were observed and number of times of salvage fentanyl after extubation were compared. RESULTS.. There were no statistical significance in spontaneous respiration recovery, recovery of consciousness and extubation in four groups（P〉0.05）. Pain score in large RF group was higher and times of salvage fentanyl was more when compared to that in small RF group （P 〈 0. 05）. Pain score and salvage fentanyl were decreased in groups of which flurbiprofen axetil administered in advance. CONCLUSION. Perioperative large dose remifentanil administra- tion might induce postoperative hyperalgesia, while flurbiprofen axetil to some extent could prevent hyperalgesia induced by remifentanil and has no effect on patients recovery.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2010年第8期916-919,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
氟比洛芬酯
瑞芬太尼
超前镇痛
痛觉过敏
Flurbiprofen axetil
Remifen- tanil
Preemptive analgesia
Hyperalgesia
