氟比洛芬酯预防鼻内窥镜手术七氟醚全麻术后躁动的临床研究

目的探讨氟比洛芬酯对鼻内窥镜（functional endoscopic sinus surgery, FESS）手术七氟醚全麻术后躁动的预防作用。方法择期全麻下FESS手术40例，美国麻醉医师协会（ the American Society of Anesthesiologists, ASA） Ⅰ～Ⅱ级健康成人，采用随机双盲对照方法，将患者分成3组，术毕前15分钟分别静脉注射氟比洛芬酯50mg（实验组T组），芬太尼1μg·kg^-1（对照组F组），等体积生理盐水组（空白对照组C组）。记录患者入手术室后10分钟（T1）、插管后5分钟（T2）、手术开始后5分钟（T3）、拔管后5分钟（T4）的心率、平均动脉压；观察各组术后躁动发生率、清醒情况、拔管时间和恶心呕吐发生率。结果①与C组相比，T组和F组拔管后躁动发生率明显减少（P〈0．05）；②c组患者与T组和F组相比，拔管后5分钟心率和平均动脉压明显增高（P〈0．05）；③T组拔管时间和苏醒时间与c组相当，均明显少于F组（P〈0．05）；④三组恶心呕吐发生率无明显差剐。结论健康成人静脉注射50mg氟比洛芬酯可以减少FESS手术七氟醚全麻术后躁动的发生，不明显延长拔管苏醒时间，不增加恶心呕吐发生率。

Intravenous flurbiprofen axetil injection as a suppressant of agitation after functional endosoopic sinus surgery with sevoflurane general anesthesia

Objective To investigate the effects of the intravenously administra-tion of flurbiprofen axetil injection on agitation after functional endoscopic sinus surgery with sevoflurane general anesthesia. Methods A total of 40 patients aged from 18 years to 60 years in good health (ASA physical status Ⅰ～Ⅱ ) undergoing elective functional endoscopic sinus surgery were randomly and respectively divided into three groups. The patients were induced with fentanyl and propofol and rocuronium, and maintained with 2.5%～3.5% sevoflurane and oxygen. In group T, flurbiprofen axetil injection 50mg were administrated 15 minutes before the end of operation, and fentanyl 1μg/kg in group F, and in group C was given an equal volume of NS. The heart rate (HR), mean arterial blood pressure (MAP) were assessed during the anesthesia. The extubation time, waking time, postoperative agitation, nausea and vomiting were observed and recorded. Results The agitation was remarkably suppressed in group T and group F than group C. And there was a significant difference in mean heart rate and mean arterial blood pressure in group C compared with group T and F. And the extubation time and waking time were almostly the same in group T and group C, and both shorter than that in group F. The rate of nausea and vomiting were not increased in the group T. Conelusion It is safe and feasible to give flurbiprofen axetil injection 50mg to reduce agitation after functional endoscopic sinus surgery with sevoflurane general anesthesia.