氟比洛芬与奈福泮用于自控静脉镇痛效果比较

    Comparison of effects between furbiprofen and nefopam in patient-controlled intravenous analgesia

    • 摘要: 目的:比较氟比洛芬酯与奈福泮用于自控静脉镇痛(patient-controlled intravenous analgesia,PCIA)的临床效果。方法:择期全麻手术90例(腹部和开胸手术),随机分成3组,每组30例。A组:氟比洛芬100mg+芬太尼0.35mg;B组:氟比洛芬100mg;C组:盐酸奈福泮100mg+芬太尼0.35mg。3组均用0.9% NaCl稀释至100ml。A组和B组在全麻插管后即静脉注射(静注)氟比洛芬酯50mg,C组在手术结束前10min静注盐酸奈福泮20mg。参数设定:持续输注量为2ml/h,PCIA为2ml,锁定时间10min。所有患者术毕静注恩丹西酮4mg。观察术后2h、4h、8h、16h、24h、36h的视觉模拟镇痛评分(VAS)和相关的不良反应,记录36h内PCIA按压次数,调查PCIA的基本满意度。结果:所有患者均即时清醒拔管。A组在各时段VAS和按压总次数均显著低于B、C组(P<0.01),B组与C组差异无统计学意义(P>0.05)。不良反应中咽喉痛和精神症状C组显著高于A组和B组(P<0.01),而A组与B组差异无统计学意义(P>0.05);A组满意度显著高于B组和C组。结论:氟比洛芬与盐酸奈福泮均可行PCIA;在复合同等小剂量芬太尼时,氟比洛芬效果更加满意,不良反应发生率少,值得临床推广。

       

      Abstract: Objective: To compare the clinical effects between furbiprofen and nefopam in patient-controlled intravenous analgesia(PCIA).Methods: Ninety patients with selective general anesthesia were randomly divided into three groups:Group A(n=30) was given 100 ml mixture solution of furbiprofen 100 mg,fentanyl 0.35mg and 0.9% NaCl;Group B(n=30) was given 100 ml mixture solution of furbiprofen 100 mg and 0.9% NaCl;Group C(n=30) was given 100 ml mixture solution of nefopam 100 mg,fentanl 0.35 mg and 0.9% NaCl.The patients in Group A and Group B were injected furbiprofen intravenously 50mg immediately after intubation,while Group C patients were injected nefopam 20 mg intravenously 10 minutes before the end of operation.All the patients were injected ondansetron 4 mg intravenously after operation.VAS and associated bad responses were observed 2 hours,4 hours,8 hours,16 hours,24 hours,and 36 hours after operation.The number of PCIA within 36 hours was recorded and the satisfaction of PCIA was investigated.Results: All the patients were smooth after operation.VAS at every time point and the number of PCIA in Group B and Group C were significantly higher than those in Group A(P<0.01).There was no significant difference between Group B and Group C.Throat pain and bad responses of spirit discomfort in Group C were significantly higher than those in Group A and Group B(P<0.01) and there was no significant difference between Group A and Group B(P>0.05);The satisfactory degree in Group A was significantly higher than Group B and Group C.Conclusions: Both furbiprofen and nefopam can be used in PICA.The effect of furbiprofen is much more satisfactory than fentanyl with the same small amount and the bad responses are much less.

       

    /

    返回文章
    返回