国际麻醉学与复苏杂志   2010, Issue (2): 103-105
    
氟比洛芬酯超前镇痛减轻全麻气管拔管后副作用
卢静1()
1.276003 山东省临沂市人民医院麻醉科
Preoperative intravenous flurbiprofen reduces adverse effect after extubation in osteo-operations undergoing general anesthesia
 全文:
摘要：

目的 探讨术前使用氟比洛芬脂是否可减轻全麻患者苏醒期副作用。方法 选择75例ASA I级～II 级患者，年龄30岁～50岁，拟在全麻下行腰椎固定手术。随机双盲分为3组，对照组、术前组、术后组，对照组(C)：手术前30 min及手术结束前30 min静脉均注射安慰剂；术前组(Pr)：手术前30 min和手术结束前30 min静脉分别注射1 mg/kg氟比洛酚脂和安慰剂；术后组(Po)：手术前30 min和手术结束前30 min分别静脉注射安慰剂和1 mg/kg氟比洛芬脂。结果 Pr、Po 两组术后咽喉痛发生率分别为 2/25、6/25，躁动评分分别为 0.51±0.31、1.52±0.51，C 组咽喉痛发生率和躁动评分分别为 14/25、2.82±0.41。Pr、Po两组均低于 C 组（P< 0.05），Pr 组术后咽喉痛发生率和躁动评分明显低于 Po 组（P< 0.05）；Pr、Po 两组身体舒适度评分分别为4.73±0.50、3.00±0，镇静评分分别为2.16±0.26、2.06±0.21，C 组身体舒适度和镇静评分分为 2.21±0.42、1.46±0.25。Pr、Po两组明显高于 C 组（P<0.05），Pr组身体舒适度评分又明显高于Po 组（P<0.05），Pr、Po两组镇静评分比较差异无统计学意义；三组患者均未发现恶心、呕吐。Pr、Po 两组拔管后肾上腺皮质激素、血糖增高值明显低于 C 组（P< 0.05），且 Pr 组苏醒期肾上腺皮质激素、血糖增高值又明显低于 Po 组（P<0.05）。结论 术前30 min使用氟比洛芬脂1 mg/kg可减轻全麻患者拔管后副作用，提高苏醒质量。
关键词： 氟比洛芬酯；超前镇痛；副作用
Abstract:

Objective To assesswhether preoperative intravenousadministration offlurbiprofen , a non-steroidal anti-inflammatory drug, reduces tracheal extubation-induced adverse effects. Methods Sixty patients undergoing lumbar vertebra fixation with general anesthesia were randomly assigned to one of three groups（n=20）. Placebo（group C and group Post）or flurbiprofen（group Pre）was injected 30 min before surgery；and placebo（group C and group Pre）orflurbiprofen（group Post）was injected 30 min before surgery termination. Results Groups were comparable for age，weight，sex，operation duration，extubation time and intraoperative blood loss.The incidence of postoperative throatache in PRE group and POST group was respectively 2/25、6/25. RS in PRE group and POST group was respectively 0.51±0.31、1.52±0.51. The incidence of postoperative throatache and RS in control group was respectively 14/25、2.82±0.41.PRE group and POST group were apparently lower than control group（P< 0.05）. There was significantdefference in throat ache and RS between PRE group and POST group（P< 0.05）. BCS ofPRE group and POST group was respectively 4.73±0.50、3.00±0. RSS of PRE group and POST group was respectively2.16±0.26、2.06±0.21. BCS and RSS of control group were respectively 2.21±0.42、1.46±0.25. RSS and BCS ofPRE group and POST group were obviously higherthan controlgroup（P< 0.05）. There was obviously defference of BCS between PRE group and POST group. Nausea and vomit were not found in three group. The increase values of cortisol and glucose of PRE group and POST group were lower than control group（P< 0.05）. There was also remarkable defference between PRE group and POST group. Conclusion Pre-operativeflurbiprofen axetilanalgesia reducestracheal extubation-induced adverse effectand improves recovery quality.
Key words: Flurbiprofen; Preemptive analgesia; Side effects