CAJ | 학술논문

目的：观察氟比洛芬酯复合舒芬太尼用于骨科手术术后镇痛的临床效应。方法：择期骨科手术患者90例,随机分为三组。A组手术结束前15min静注5ug舒芬太尼,后以舒芬太尼3ug/kg、托烷司琼8mg加生理盐水至200 ml进行镇痛；B组手术结束前15min静注氟比洛芬酯50 mg/(5 ml),术后以舒芬太尼2ug/kg、托烷司琼8mg、氟比洛芬酯100mg加生理盐水至200 ml进行镇痛；C组手术结束前15min静注氟比洛芬酯50 mg/(5 ml),术后以舒芬太尼1ug/kg、托烷司琼8mg、氟比洛芬酯100mg加生理盐水至200 ml进行镇痛。所有患者的镇痛泵均为4 ml/h,持续输注。术后随访病人,记录术后(4、8、12、24、48)h的疼痛、镇静评分。随访时同时记录：①生命体征；②各种不良反应情况包括恶心呕吐、皮肤瘙痒、呼吸抑制等。结果：A组和B组在镇痛效果上无显著差异,B组和C组比较在术后4小时和8小时VAS评分B组优于C组；A组镇静在术后4、8h评分达3分以上者明显多于B组、C组,有显著性差异(P<0.05)；不良反应情况：三组病人术后生命体征平稳,均未出现严重呼吸循环抑制、皮肤瘙痒及异常出血等严重并发症,A组不良反应发生率高于B、C组(P均<0.01)。结论：氟比洛芬酯与舒芬太尼联合应用于术后镇痛可以达到满意的镇痛效果,同时减少了围术期不良反应的发生,是一种值得临床推广的安全有效的镇痛方法。
목적：관찰불비락분지복합서분태니용우골과수술술후진통적림상효응。방법：택기골과수술환자90례,수궤분위삼조。A조수술결속전15min정주5ug서분태니,후이서분태니3ug/kg、탁완사경8mg가생리염수지200 ml진행진통；B조수술결속전15min정주불비락분지50 mg/(5 ml),술후이서분태니2ug/kg、탁완사경8mg、불비락분지100mg가생리염수지200 ml진행진통；C조수술결속전15min정주불비락분지50 mg/(5 ml),술후이서분태니1ug/kg、탁완사경8mg、불비락분지100mg가생리염수지200 ml진행진통。소유환자적진통빙균위4 ml/h,지속수주。술후수방병인,기록술후(4、8、12、24、48)h적동통、진정평분。수방시동시기록：①생명체정；②각충불량반응정황포괄악심구토、피부소양、호흡억제등。결과：A조화B조재진통효과상무현저차이,B조화C조비교재술후4소시화8소시VAS평분B조우우C조；A조진정재술후4、8h평분체3분이상자명현다우B조、C조,유현저성차이(P<0.05)；불량반응정황：삼조병인술후생명체정평은,균미출현엄중호흡순배억제、피부소양급이상출혈등엄중병발증,A조불량반응발생솔고우B、C조(P균<0.01)。결론：불비락분지여서분태니연합응용우술후진통가이체도만의적진통효과,동시감소료위술기불량반응적발생,시일충치득림상추엄적안전유효적진통방법。
Objective:To observe the clinical effects of flurbiprofen axeyil combined sufentanil in postoperative analgesia of orthopaedic surgery patients.Methods:Ninety cases of patients undergoing elective orthopedic surgery, were randomly divided into three groups. In group A, there was the intravenous infusion of sufentanil 3ug/kg+tropisetron 8mg+saline, the total amount of 200ml, after the first 5ug sufentanil 15min before the end of surgery. In group B, after the first 50mg/(5 ml) flurbiprofen axeyil 15 min before the end of surgery, there was the intravenous infusion of sufentanil 2ug/kg+tropisetron 8mg+flurbiprofen axeyil 100mg+saline, the total amount of 200ml. In group C, there was the intravenous infusion of sufentanil 1ug/kg+tropisetron 8mg+flurbiprofen axeyil 100mg+saline, the total amount of 200ml, after the first 50mg/(5 ml) flurbiprofen axeyil 15min before the end of surgery . All the analgesia pump are 4 ml/h and continuous infusion. Postoperative analgesia and sedate efficacy was assessed at 4h, 8h, 12h, 24h and 48h after surgery. Also record:(1) vital signs;(2) a variety of adverse reactions include nausea and vomiting, skin itching, respiratory depression, etc.Results:Between group A and group B there was no significant difference on analgesia effect, but the VAS score at 4h and 8h after surgery of group B was better than that of group C;The patients with the sedation scores equal to or greater than 3 in Group A at postoperative 4h and 8h were more than group B and group C, there was significant difference (P<0.05);Adverse reactions:three groups of patients had stable vital signs, and did not appear serious respiratory inhibition, itchy skin, and a severe complication such as abnormal bleeding.The incidence of adverse reaction of group A was higher than B and C group (P<0.01).Conclusion:Flurbiprofen axeyil combined with sufentanil used in postoperative analgesia can achieve satisfactory analgesia effect, at the same time reduce the perioperative incidence of adverse reactions.It is a kind of safe and effective analgesic method to be worth clinical promotion.