氟比洛芬酯复合不同剂量布托啡诺用于老年患者胃癌术后静脉自控镇痛

摘要

Objective To observe the efficacy and safety of postoperative PCIA with both flurbiprofen axetil and butorphanol after senile gastric cancer surgery. Methods Eighty general anesthesia patients ( ASA Ⅰ or Ⅱ grade, 65 to 75 years) undergoing selective gastric cancer surgery were randomly divided into four groups: Group Ⅰ (butorphanol 8 mg) , Group Ⅱ (butorphanol 4 mg + flurbiprofen axetil 200 mg) 、 Group Ⅲ ( butorphanol 6 mg + flurbiprofen axetil 200 mg ) and Group Ⅳ ( butorphanol 8mg + flurbiprofen axetil 200 mg). The visual analogue scale of postoperative pain and Ramsay sedative scores , the numbers of pressing times within 48 h, and the incidence of adverse reactions at 0 h( T0) ,6 h( T1 ) ,12 h( T2 ) ,24 h( T3 ) and 48 h( T4 ) postoperatively were recorded. Results VAS scores and the numbers of pressing times in patients of group Ⅲ and Ⅳ were less than those in group Ⅰ and Ⅱ within T1 ～ T4 ( P 〈 0. 05 ). Ramsay sedative scores in group Ⅱ and Ⅲ were lower than those in group Ⅰ and Ⅲ within T1 ～ T3 ( P 〈 0. 05 ) . The incidences of lethargy in group Ⅱ and Ⅲ were significantly lower than those in group Ⅰ and Ⅳ ( P 〈 0. 05 ) . Conclusion Flurbiprofen axetil 200 mg combined with butorphanol 6 mg can provide satisfactory postoperative analgesia for senile gastric cancer patients with less adverse events.%目的 观察氟比洛芬酯复合不同剂量布托啡诺用于老年患者胃癌术后静脉自控镇痛(PCIA)的效果和安全性.方法 80例年龄65～75岁,ASAⅠ～Ⅱ级,择期全身麻醉下胃癌根治术患者,随机均分为Ⅰ组(布托啡诺8 mg)、Ⅱ组(布托啡诺4 mg+氟比洛芬酯200 mg)、Ⅲ组(布托啡诺6 mg+氟比洛芬酯200 mg)和Ⅳ组(布托啡诺8 mg+氟比洛芬酯200 mg).观察并记录四组患者术毕即刻(T0)及术后6 h(T1)、12 h(T2)、24 h(T3)、48 h(T4)镇痛、镇静评分,以及术后48 h内PCIA泵有效按压次数及不良反应的发生情况.结果 Ⅲ、Ⅳ组在T1～T4时镇痛评分和PCIA泵有效按压次数显著低于Ⅰ、Ⅱ组(P<0.05),T1～T3时Ⅱ、Ⅲ组镇静评分显著低于Ⅰ、Ⅳ组(P<0.05).术后48 h内Ⅰ、Ⅳ组嗜睡发生率显著高于Ⅱ、Ⅲ组(P<0.05).结论 氟比洛芬酯200 mg复合布托啡诺6 mg静脉自控镇痛可为老年胃癌患者提供良好的术后镇痛效果且不良反应少.