[1]郭新玲,李静阳,刘勤楠,等.氟比洛芬酯超前镇痛对功能性鼻内镜鼻窦手术患者术后疼痛及炎症反应的影响[J].新乡医学院学报,2021,38(1):052-56.[doi:10.7683/xxyxyxb.2021.01.011]
 GUO Xinling,LI Jingyang,LIU Qinnan,et al.Effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammation in patients undergoing functional endoscopic sinus surgery[J].Journal of Xinxiang Medical University,2021,38(1):052-56.[doi:10.7683/xxyxyxb.2021.01.011]
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氟比洛芬酯超前镇痛对功能性鼻内镜鼻窦手术患者术后疼痛及炎症反应的影响
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年1
页码:
052-56
栏目:
临床研究
出版日期:
2021-01-05

文章信息/Info

Title:
Effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammation in patients undergoing functional endoscopic sinus surgery
作者:
郭新玲1李静阳1刘勤楠1王 琳1王 哲1刘桂平2刘和平1
(1.新乡医学院第三附属医院麻醉科,河南 新乡 453003;2.新乡医学院第三附属医院公共卫生科,河南 新乡 453003)
Author(s):
GUO Xinling1LI Jingyang1LIU Qinnan1WANG Lin1WANG Zhe1LIU Guiping2LIU Heping1
(1.Department of Anesthesiology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China2.Department of Public Health,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
氟比洛芬酯超前镇痛功能性鼻内镜鼻窦手术疼痛炎症反应
Keywords:
flurbiprofen axetilpreemptive analgesiafunctional endoscopic sinus surgerypaininflammation
分类号:
R614
DOI:
10.7683/xxyxyxb.2021.01.011
文献标志码:
A
摘要:
目的 观察氟比洛芬酯超前镇痛对功能性鼻内镜鼻窦手术(FESS)患者术后疼痛及炎症反应的影响。方法 选择2019年2月至2020年2月于新乡医学院第三附属医院择期行全身麻醉下FESS的60例慢性鼻窦炎患者为研究对象,按手术日期的单、双日分为观察组与对照组,每组30例。观察组患者在麻醉诱导前缓慢静脉推注氟比洛芬酯50 mg,对照组患者在麻醉诱导前给予9 g·L-1氯化钠注射液5 mL。2组患者均给予咪达唑仑0.05 mg·kg-1、舒芬太尼 0.4 μg·kg-1、丙泊酚2.0 mg·kg-1、苯磺酸顺阿曲库铵0.15 mg·kg-1进行麻醉诱导。比较2组患者拔管时及术后1、6、24、48 h的心率(HR)和平均动脉压(MAP),采用视觉模拟评分法(VAS)评估患者疼痛情况;记录2组患者术后48 h内镇痛泵的有效按压次数;比较2组患者拔管时、拔管后1 min和5 min躁动评分(RS)。采用酶联免疫吸附试验法检测2组患者术前及术后24、48 h血清中超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。比较2组患者术后不良反应发生情况。结果 2组患者拔管时HR及MAP显著高于术后1、6、24、48 h(P<0.05);2组患者术后1、6、24、48 h="" 之间hr及map比较差异无统计学意义(P>0.05)。拔管时及术后1、6、24、48 h,观察组患者HR及MAP显著低于对照组(P<0.05)。拔管时观察组患者VAS评分与对照组比较差异无统计学意义(P>0.05);术后1、6、24、48 h,观察组患者VAS评分显著低于对照组(P<0.05)。2组患者拔管时vas评分显著低于术后1、6、24、48 h(P<0.05);观察组患者术后1、6、24、48 h="" 之间vas评分比较差异无统计学意义(P>0.05);对照组患者术后1 h VAS评分显著低于术后6、24、48 h(P<0.05);对照组患者术后6、24、48 h之间vas评分比较差异无统计学意义(P>0.05)。观察组术后48 h内镇痛泵的有效按压次数显著低于对照组(P<0.05)。拔管时及拔管后1,5 min,观察组患者RS评分显著低于对照组(P<0.05);2组患者拔管后1、5 min RS评分显著低于拔管时(P<0.05);2组患者拔管后5 min RS评分显著低于拔管后1 min(P<0.05)。2组患者术前血清中 hs-CRP、TNF-α和IL-6水平比较差异无统计学意义(P>0.05);2组患者术后24、48 h血清中 hs-CRP、TNF-α和IL-6水平显著高于术前 (P<0.05);2组患者术后48 h 血清中 hs-CRP、TNF-α和IL-6水平显著高于术后24 h(PP<0.05)。>结论 氟比洛芬酯超前应用于FESS患者,能够有效减轻患者血流动力学波动及拔管时躁动程度,降低术后机体炎症反应程度及不良反应的发生率,镇痛效果显著。undefinedundefinedundefinedundefinedundefined/i="">/i="">
Abstract:
Objective To observe the effect of preemptive analgesia with flurbiprofen axetil on postoperative pain and inflammation in patients underwent functional endoscopic sinus surgery (FESS).Methods  A total of 60 patients who underwent FESS under general anesthesia in the Third Affiliated Hospital of Xinxiang Medical University from February 2019 to February 2020 were selected as study subjects,and they were divided into the observation group and control group according to the operation date,with 30 patients in each group.The patients in the observation group were injected intravenously 50 mg of flurbiprofen axetilslowly before anesthesia,and the patients in the control group were injected 5 mL of 9 g·L-1 sodium chloride.All patients were induced by intravenous anesthesia with miduzolam 0.05 mg·kg-1,sufentanil 0.4 μg·kg-1,Propofol 2.0 mg·kg-1,cisatracurium besylate 0.15 mg·kg-1.The changes of mean arterial pressure (MAP),heart rate (HR) of the patients were compared between the two groups at the time points of extubation and 1,6,24,48 h after operation.The pain of all patients were evaluated by visual analogue scale(VAS).The effective press numbers of analgesia pump within 48 h were recorded.Restlessness scores (RS) of patients were compared between the two groups at the time paints of extubation and 1,5 min after extubation.The levels of serum hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α (TNF-α)and interleukin-6 (IL-6) of patients in the two groups were analyzed by enzyme linked immunosorbent assay before operation and 24,48 h after operation.The postoperative adverse reactions of patients were observed and compared between the two groups.Results The HR and MAP of patients in the two groups at the time point of extubation were significantly higher than those at 1,6,24,48 h after operation (P<0.05).There was no significant difference in the HR and MAP of patients between the time points at 1,6,24,48 h after operation in the two groups (P>0.05).The HR and MAP of patients in the observation group were significantly lower than those in the control group at the time points of extubation and 1,6,24,48 h after operation (P<0.05).There was no significant difference in the VAS scores of patients between the two groups at the time point of extubation(P>0.05).The VAS scores of patients in the observation group were significantly lower than those in the control group at 1,6,24,48 h after operation (P<0.05).The VAS scores of patients at the time point of extubation were significantly lower than those at 1,6,24,48 h after operation (P<0.05).There was no significant difference in the VAS scores of patients in the observation group at 1,6,24,48 h after operation(P>0.05).The VAS scores of patients in the control group at 1 h after operation were significantly lower than those at 6,24,48 h after operation (P<0.05).There was no significant difference in the VAS scores of the patients in the control group at 6,24,48 h after operation(P>0.05).The effective press number of analgesia pump within 48 h of patients in the observation group was significantly lower than that in the control group(P<0.05).At the time points of extubation and 1,5 min after extubation,the RS of patients in the observation group was significantly lower than that in the control group(P<0.05).The RS of patients in the two groups at 1,5 min after extubation was significantly lower than that at the time point of extubation(P<0.05).The RS of patients in the two groups at 5 min after extubation was significantly lower than that at 1 min after extubation(P<0.05).Before operation,there was no significant difference in the levels of serum hs-CRP,TNF-α and IL-6 of patients between the two groups (P>0.05).The levels of serum hs-CRP,TNF-α and IL-6 of patients in the two groups at 24,48 h after operation were significantly higher than those before operation (P<0.05).The levels of serum hs-CRP,TNF-α and IL-6 of patients in the two groups at 48 h after operation were significantly higher than those at 24 h after operation(P<0.05).The levels of serum hs-CRP,TNF-α and IL-6 of patients in the observation group were significantly lower than those in the control group at 24,48 h after operation (P<0.05).The incidence of adverse reactions of patients in the observation group and control group was 3.33%(1/30),36.67%(11/30),respectively;the incidence of adverse reactions of patients in the observation group was lower than that in the control group (P<0.05).Conclusion Flurbiprofen axetil preemptively used in patients with FESS can effectively relieve the fluctuation of hemodynamics,reduce the degree of agitation during extubation and postoperative inflammatory reaction,and reduce the incidence of adverse reactions,its analgesic effect is remarkable.

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更新日期/Last Update: 2021-01-05