氟比洛芬酯复合地佐辛在肋软骨隆鼻术中多模式超前镇痛作用

摘要

Objective To determine the preemptive multimodal analgesia effect of flurbiprofen axetil combined with dezocine in patients undergoing augmentation rhinoplasty using costal cartilage. Methods 80 cases of rhinoplasty using costal cartilaginous were selected and divided into 4 groups randomly, 20 cases in each group. Five minutes before induction of anesthesia, the control group was given 5ml normal saline intravenously, flurbiprofen axetil group was given flurbiprofen axetil 1mg/kg intravenously, dezocine group was given dezocine 0.1mg/kg intravenously, flurbiprofen axetil combined with dezocine group was given flurbiprofen axetil 1mg/kg + dezocine 0.1mg/kg intravenously. The time of extubation and recovery of consciousness were recorded at the end of the operation. The SAS score of 1,3 and 5min after extubation and the NRS score of 1, 3, 6,24h after extubation were measured, and the number of patients who needed rescue anesthetics was recorded for each group. Results There were no statistical significance for consciousness recovery time and extubation time of four groups(P>0.05). The SAS scores of 1,3 and 5min after extubation in flurbiprofen axetil combined with dezocine group were lower than those of the control group(P<0.05). The NRS scores of 1,3,6,24h after extubation of flurbiprofen axetil combined with dezocine group were lower than those of the other groups(P<0.05). The number of patients who needed rescue anesthetics in flurbiprofen axetil combined with dezocine group was the least(P<0.05). Conclusion The preemptive multimodal analgesia with flurbiprofen axetil combined with dezocine is more effective than single use flurbiprofen axetil or dezocine in patients undergoing augmentation rhinoplasty using costal cartilage.%目的:探讨氟比洛芬酯复合地佐辛在肋软骨隆鼻术中行多模式超前镇痛的应用效果.方法:选择肋软骨隆鼻就医者80例,随机双盲分为4组,每组20例.麻醉诱导前5min,对照组给予静注生理盐水5ml,氟比洛芬酯组静注氟比洛芬酯1mg/kg,地佐辛组静注地佐辛0.1mg/kg,氟比洛芬酯复合地佐辛组静注氟比洛芬酯1mg/kg+地佐辛0.1mg/kg.术毕记录拔管时间、意识恢复时间,拔管后1、3、5min的镇静躁动评分(Sedation agitation score, SAS).拔管后1、3、6、24h的疼痛评定数字量表(Numerical rating scale, NRS)评分,及各组需要镇痛药物补救例数.结果:四组就医者拔管时间、意识恢复时间比较,差异无统计学意义(P>0.05);与对照组比较,氟比洛芬酯复合地佐辛组拔管后1、3、5min的SAS评分均降低,差异有统计学意义(P<0.05);与对照组、氟比洛芬酯组、地佐辛组比较,氟比洛芬酯复合地佐辛组拔管后1、3、6、24h的NRS评分均降低(P<0.05);需镇痛药物补救例数氟比洛芬酯复合地佐辛组<氟比洛芬组、地佐辛组<对照组,各组间比较差异有统计学意义(P<0.05).结论:应用氟比洛芬酯复合地佐辛对肋软骨隆鼻就医者行多模式超前镇痛,效果确切,优于单独使用氟比洛芬酯或地佐辛.