国际麻醉学与复苏杂志   2013, Issue (12): 5-5
    
氟比洛芬酯和曲马多应用于七氟醚麻醉超前镇痛的比较
王琦1()
1.武汉市协和医院麻醉科
The comprasion of flurbiprofen axetil and tramadol in sevoflurane general anasthesia
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摘要:

目的 比较氟比洛芬酯和曲马多在七氟醚全身麻醉术前应用的效果及对其苏醒期躁动的预防作用。方法 60例择期肝胆手术患者随机分成氟比洛芬酯组(F组)﹑曲马多组(T组)和生理盐水组(N组),每组20例。手术开始前10min,F组静注氟比洛芬酯1mg/kg,T组静注曲马2mg/kg,N组静注生理盐水10ml,分别于麻醉诱导前T1,拔除气管导管前T2(停药10min),拔管时T3,拔管后10minT4,观察三组MAP、HR、SpO2、睁眼时间、拔管时间、术后疼痛评分和躁动分级。结果T﹑F组在拔除气管导管前T2(停药10min),拔管时T3,拔管后10minT4三个时间点的血压﹑心率明显低于N组(P<0.05或P<0.01),因均在吸氧无SpO2低者。睁眼及拔管时间F﹑N组明显短于T组(P<0.05或P<0.01)。躁动发生率F﹑T组明显低于N组(P<0.05或P<0.01)。VAS评分术后0.5h﹑2h,A﹑B组明显低于N组(P<0.05)。结论:氟比洛芬酯和曲马多用于七氟醚全身麻醉可产生良好的超前镇痛作用,并可预防术后躁动的发生,但曲马多对患者的苏醒有延迟作用

关键词: 氟比洛芬酯;曲马多;超前镇痛;苏醒期躁动
Abstract:

Objective To compare the effect of preemptive analgesia induced by flurbiprofen axetil and tramadol in sevoflurane general anasthesia and evaluate the preventive effect of flurbiprofen axetil and tramadol on postoperative agitation。Methods Sixty ASAⅠ~Ⅱpatients undergoing hepatolobectomy or cholecystectomy were randomly assigned into three groups,which received either a bolus of 1mg/ml flurbiprofen axetil (group F,20 cases) or 1mg/ml tramadol(group T,20 cases) or 10 ml normal saline (group T,20 cases),10 minutes before the surgery .Recording the heart rate(HR),mean arterial blood pressure(MAP),and saturation of pulse oxygen(SpO2) before induction of anesthesia and around extubation. The moment of eyes opening and extubation were recorded,as also as the degree of postoperative agitation . Results The MAP、HR of F and T groups were much lower than N group around extubation(P<0.05 or P<0.01),no one have low SpO2 for the sustain oxygen .Eyes opening and extubation of F group was much shorter than T group(P<0.05).The emergence of postoperative agitation of F group and T group much better than C group(P<0.05 or P<0.01)and the visual analogue score of F group and T group after the operation finished 0.5h and 2h are much better than N group(P<0.05). Conclusion Applying flurbiprofen axetil and tramadol in sevoflurane general anasthesia can provide a good effect of preemptive analgesia and prevent postoperative agitation .But tramadol can prolong the waking time of patients.

Key words: flurbiprofen axetil; tramadol;preemptive analgesia;postoperative agitation