| 程会会,孟庆涛.氟比洛芬酯联合纳布啡对全身麻醉下成人扁桃体切除术后镇痛效果观察[J].安徽医药,2019,23(11):2283-2287. |
| 氟比洛芬酯联合纳布啡对全身麻醉下成人扁桃体切除术后镇痛效果观察 |
| Analgesic effect of flurbiprofen axetil combined with nabocone in patients undergoing tonsillectomy under general anesthesia |
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| DOI：10.3969/j.issn.1009?6469.2019.11.043 |
| 中文关键词: 扁桃体切除术 氟比洛芬酯 纳布啡 疼痛测定 Ramsay镇静评分 |
| 英文关键词: Tonsillectomy Flurbiprofen ester Nabuprofen Pain measurement Ramsay sedation score |
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| 中文摘要: |
| 目的探讨全身麻醉下成人扁桃体切除术后应用氟比洛芬酯联合纳布啡镇痛效果。方法选取 2017年 8月至 2018年 8月武汉大学人民医院东院择期在全身麻醉下行扁桃体切除术并要求术后镇痛的扁桃体肥大病人 120例，采用随机数字表法分为三组，氟比洛芬酯( F)组、纳布啡( N)组和氟比洛芬酯联合纳布啡( FN)组，每组 40例。 F组手术结束前静脉注射氟比洛芬酯 50 mg，接镇痛泵氟比洛芬酯 150 mg+托烷司琼 10 mg+0.9%氯化钠溶液，配制成 100 mL溶液。 N组手术结束前静脉注射纳布啡 10 mg，接镇痛泵纳布啡 60 mg+托烷司琼 10 mg+0.9%氯化钠溶液，配制成 100 mL溶液。 FN组手术结束前静脉注射地塞米松 10 mg，接镇痛泵氟比洛芬酯 100 mg+纳布啡 40 mg+托烷司琼 10 mg，配制成 100 mL溶液。三组均采用视觉模拟评分法(VAS)对术后 1、3、6、9、12、24、36 h的疼痛进行评分，采用 Ramsay评分对术后 1、3、6、9、12、24、36 h的镇静进行评分；记录三组 8、12、24 h静脉自控镇痛( PCIA)给药次数超过 5次的病例数；比较三组术后镇痛满意度；记录三组术后镇痛期间不良反应发生情况。结果三组均能达到良好的镇痛、镇静效果， FN组静息时各时间点 VAS疼痛评分高于 F组( P＜0.05)N组静息时各时间点 VAS疼痛评分与 F组比较，差异无统计学意义( P＞0.05)； F组和 N组术后各时间点 Ramsay镇静评分比较差，异无统计学意义( P＞0.05)术后 3、6、24、36 h FN组 Ramsay镇静评分高于 F组和 N组，差异有统计学意义( P＜0.05)；镇痛满意度评价满意者 FN组( 38例)，高于 F组( 30例)(P＜0.05)；术后恶心呕吐、头晕头痛、皮肤瘙痒、尿潴留发生率 FN组分别为 2、1、0、1例，明显低于 F组(4、4、4、4例)(P＜0.05)；呼吸抑制发生率 FN组(2例)低于 F组(5例)(P＜0.05)；烦躁发生率 FN组(1例)低于 F组(2例)和 N组(2例)(P＜0.05)。结论氟比洛芬酯联合纳布啡在成人扁桃体切除术后镇痛方面有显著效果，且较为安全。 |
| 英文摘要: |
| Objective To investigate the analgesic effect of flurbiprofen axetil combined with naboin in adult patients undergoing tonsillectomy.Methods A total of 120 patients undergoing tonsillectomy in the Renmin Hospital of Wuhan University from August2017 to August 2018 were selected and randomly divided into 3 groups，flurbiprofen ester(F)group，nalbuphine(N)group and flur? biprofen ester combined with nalbuphine(FN)group，with 40 cases in each group.In group F，50 mg flurbiprofen axetil was injected intravenously before operation，and 150 mg flurbiprofen axetil + tropisetron 10 mg + saline was used as analgesic pump to prepare 100 mL solution.In group N，10 mg of nabuprofen was injected intravenously before operation，and 100 mL of nabuprofen 60 mg + tropisetron 10 mg + saline solution was prepared by analgesia pump.In FN group，10 mg dexamethasone was injected intravenouslybefore operation and 100 mg flurbiprofen axetil + 40 mg nabuprofen + 10 mg tropisetron was used as analgesic pump to prepare 100mL solution.Visual analogue scale(VAS)was used to evaluate the pain from the first hour to the 36th hour after operation，twice a day，Ramsay sedation score was used，and the adverse reactions such as the times of PCIA compression，nausea and vomiting，respira? tory depression were recorded.Results All 3 groups can achieve good analgesic and sedative effects.Resting VAS score and Ram?say sedation score in group FN were significantly higher than those in group F(P＜0.05).There was no significant difference in VAS score at rest time between group N and group F.The incidence of postoperative nausea，vomiting，dizziness，headache，skin itch? ing and urine retention in FN group was significantly lower than that in F group(P＜0.05).The incidence of respiratory depression and FN was lower than that of F group(P＜0.05)，and the incidence of irritability in FN group and N group was lower than that of F group(P＜0.05).Patient satisfaction in group FN and group N was significantly higher than that in group F(P＜0.05).Conclusion Flurbiprofen combined with nalbuphine has a significant effect on analgesia after tonsillectomy in adults and is relatively safe. |
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