氟比洛芬酯复合舒芬太尼用于卵巢癌根治术病人静脉自控镇痛的临床研究

目的评价氟比洛芬酯复合舒芬太尼用于卵巢癌根治术患者静脉自控镇痛（PCIA）的安全性和有效性。方法60例择期行卵巢癌根治术的患者，根据术后PCIA用药方法的不同，分为3组，20例／组：S组：舒芬太尼150p,g；F组：氟比洛芬酯200mg；FS组：氟比洛芬酯100mg＋舒芬太尼100Ixg；每组均加入阿扎司琼10mg，用0．9％氯化钠稀释至100ml行PCIA。采用疼痛视觉模拟评分（VAS评分）和Ramesay镇静评分评估患者术后48h内的疼痛和镇静程度，同时记录不良反应。结果3组镇痛效果良好，F组患者术后2h的疼痛VAS评分（3．3±0．8）高于S组（2．6±1．0）和Fs组（2．8±1．1）（P〈0．05）。S组患者术后2和4h的Ramesay镇静评分（3．8±0．9，3．6±0．5）高于F组（2．4±0．8，2．3±0．6）和FS组（2．9±0．8，2．6±0．4）（P〈0．05），术后8h及以后时点差异无统计学意义（P〉0．05）。观察期间s组恶心、呕吐、嗜睡不良反应发生率（20％，15％，20％）高于F（5％，0，5％）和FS组（5％，5％，5％）（P〈0．05）。镇痛期间的患者的腹腔引流量差异无统计学意义（P〉0．05）。3组病人镇痛期间均未发生呼吸抑制、异常出血等并发症。结论氟比洛芬酯复合舒芬太尼PCIA可安全有效用于卵巢癌根治术后疼痛治疗，可显著减少阿片类药物的用量和降低不良反廊的发牛率。

Application of intravenous flurbiprofen axeyil injection combined with sufentanil for postoperative analgesia of ovarian cancer radical operation

Objective To evaluate the efficacy and safety of flurbiprofen axeyil injection combined with sufentanil for postoperative patient undergoing ovarian cancer radical operation.Methods 60 postoperative patients undergoing radical ovarian cancer surgery were randomly divided into three groups with 20 cases in each group, including Sufentanil 150 μg (group S) ,Flurbiprofen Axeyil injection 200 mg (group F) ,Flurbiprofen Axeyil injection 100 mg plus Sufentanil 100 μg (group FS).The drugs in each group were added with Azasetron 10 mg and diluted to 100 ml, then infused by a pump in a rate of 2 ml/h.The visual analogue scale (VAS) and Ramesays scores were used to evaluate the analgesic effect at 0.5,2,4,8,12,24 and 48 h after surgery.The incidence of side effects was recorded.Results All the patients showed good pain relief with PCIA.The VAS of group F(3.3 +0.8) at 2 h after operation was slightly higher than that of group S (2.6 + 1.0) and SF (2.8 + 1.1) (P ＜ 0.05), which became similar 4 h later (P ＞0.05).In groups F (2.4 +0.8,2.3 +0.6) and FS(2.9 +0.8,2.6 ±0.4), the average Ramsay score was slightly lower than that in group S(3.8 +0.9,3.6 +0.5) (P ＜0.05).But the differences were not significant within 8 h after operation (P ＞ 0.05).The accidence rates of nausea, vomiting, itching, somnolence of group S(20％ ,15％ ,20％) were significantly higher than those in group F (5％ ,0,5％)and FS(5％,5％ ,5％) (P ＜0.05).No respiratory depression or abnormal bleeding occurred in three groups during the period of postoperative 48 hour.The amount of hydrothorax had no difference between 3 groups (P ＜0.05).Conclusions Intravenous postoperative analgesia with Flurbiprofen Axeyil injection combined with Sufentanil had a better analgesic effect than Sufentanil or Flurbiprofen Axeyil used alone, and it could significantly reduce the dose requirement of Sufentanil as well as its associated side effects.