氟比洛芬酯、塞来昔布超前镇痛时机对骨科全麻病人苏醒期躁动及术后镇痛的影响

王苗; 李朋斌; 王贵良; 王晓飞

doi:10.13898/j.cnki.issn.1000-2200.2021.11.012

氟比洛芬酯、塞来昔布超前镇痛时机对骨科全麻病人苏醒期躁动及术后镇痛的影响

Effect of the preemptive analgesia timing of flubiprofen axetil and celecoxib on restlessness and postoperative analgesia in orthopedic general anesthesia patients

摘要

摘要:
目的探讨氟比洛芬酯、塞来昔布超前镇痛时机对骨科全麻病人苏醒期躁动及术后镇痛的影响。
方法选择接受全身麻醉骨科手术的305例病人作为研究对象，采用随机数字表法分为FE1、FE2、CE1、CE2和C组，各61例。FE1组术前30 min静脉滴注氟比洛芬酯1 mg/kg，FE2组术前15 min静脉滴注氟比洛芬酯1 mg/kg，CE1组术前12 h和术前1 h分别口服200 mg塞来昔布，CE2组术前3 d开始口服塞来昔布每次200 mg，每12 h口服1次，C组术前不给予氟比洛芬酯和塞来昔布口服。比较5组病人拔管前躁动评分（RS）和术后1、3、6、12、24 h视觉模拟疼痛评分（VAS）和不良反应发生率。
结果5组病人拔管时RS评分差异有统计学意义（P < 0.01），其中C组拔管时RS评分均明显高于FE1、FE2、CE1和CE2组（P < 0.01），而FE1、FE2、CE1、CE2组两两比较差异均无统计学意义（P>0.05）。C组病人术后1、3、6、12、24 h的VAS评分均明显高于其他4组（P < 0.01），术后24 h均明显高于CE2组和CE1组（P < 0.01）；术后1、3 h，FE1组、FE2组、CE2组VAS评分均明显低于CE1组（P < 0.01）；术后12 h，FE1组、FE2组VAS评分均明显高于CE2组（P < 0.01）；术后24 h，FE1组、FE2组VAS评分均明显高于CE2组和CE1组（P < 0.01）。5组不良反应发生率差异无统计学意义（P>0.05）。
结论术前3 d连续给予塞来昔布对术后短期和中远期镇痛效果均显示良好效果，且未观察到不良反应增加，安全性良好，值得临床推广应用。

Abstract:
ObjectiveTo investigate the effects of the preemptive analgesia timing of flubiprofen axetil and celecoxib on restlessness and postoperative analgesia in orthopedic general anesthesia patients.
MethodsThree hundred and five patients treated with orthopaedic surgery under general anesthesia were randomly divided into the FE1, FE2, CE1, CE2 and C groups(61 cases in each group).The FE1 group was treated with 1 mg/kg of flubiprofen axetil before 30 min of operation, and the FE2 group was treated with 1 mg/kg of flubiprofen axetil before 15 min of operation.The CE1 group was given 200 mg celecoxib before 12 h and 1 h of operation, respectively.The CE2 group was given 200 mg celecoxib before 3 d of operation, once every 12 h, and the C group was not given flurbiprofen axetil or celecoxib before operation.The agitation score(RS) before extubation, visual analog pain score(VAS) after 1, 3, 6, 12 and 24 h of operation, and incidence rate of adverse reactions were compared among five groups.
ResultsThe differences of the RS scores of extubation among five groups were statistically significant(P < 0.01).The RS score of extubation in C group was significantly higher than that in FE1, FE2, CE1 and CE2 groups(P < 0.01), while there was no statistical significance among FE1, FE2, CE1 and CE2 groups(P>0.05).The VAS scores in C group after 1, 3, 6, 12 and 24 h of surgery were significantly higher than that in other 4 groups(P < 0.01), and the VAS score in C group after 24 h of surgery was significantly higher than that in CE1 and CE2 groups(P < 0.01).At 1 and 3 h after operation, the VAS scores in FE1, FE2 and CE2 groups were significantly lower than that in CE1 group(P < 0.01).After 12 h of surgery, the VAS scores in FE1 group and FE2 group were significantly higher than that in CE2 group(P < 0.01).After 24 h of surgery, the VAS scores in FE1 and FE2 groups were significantly higher than those in CE2 and CE1 groups(P < 0.01).There was no statistical significance in the incidence rate of adverse reactions among five groups(P>0.05).
ConclusionsThe continuous administration of celecoxib before 3 days of operation has good effects on short-term and medium- and long-term analgesia, does not increase the adverse reactions, and has good safety, so it is worth popularizing and applying in clinic.

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