余红++谭志林+张定秀

[摘要]目的 探討氟比洛芬酯用于鼻部手术后的镇痛效果。方法 选择2015年1月～2016年12月我院收治的60例鼻部手术患者，根据随机数字表法分为对照组与观察组，其中对照组术毕前未予药物镇痛，观察组予氟比洛芬酯镇痛，比较两组患者术后苏醒5、10、30、60 min各时间点的平均动脉压（MAP）、心率（HR）及呼吸频率（RR），并采用镇静评价分量表（OAA）、疼痛语言评分量表（VRS）对镇痛效果进行评分，记录两组患者此期间出现的不良反应。结果 两组组内不同时间点VRS、OAA评分比较差异有统计学意义（P<0.05）；观察组术后30、60 min的VRS评分显著低于对照组，术后5、10 min的OAA评分显著低于对照组，差异有统计学意义（P<0.05）；两组组内不同时间点的MAP、HR比较，差异无统计学意义（P>0.05）；观察组RR在术后5、10、30 min均显著高于对照组，差异均有统计学意义（P<0.05）。结论 氟比洛芬酯用于鼻部手术后镇痛疗效显著，可有效缓解患者术后疼痛，且对呼吸、血管等无明显抑制，安全性较高。

[关键词]氟比洛芬酯；鼻部手术；术后镇痛

[中图分类号] R971+.1 [文献标识码] A [文章编号] 1674-4721（2017）04（b）-0131-03

Clinical analysis of Flurbiprofen Axetil for postoperative analgesia after nasal surgery

YU Hong TAN Zhi-lin ZHANG Ding-xiu

Department of Anesthesiology，People′s Hospital of Xinxing County in Guangdong Province，Xinxing 527400，China

[Abstract]Objective To investigate the analgesia effect of Flurbiprofen Axetil after nasal operation.Methods A total of 60 patients undergoing nasal operation in our hospital from January 2015 to December 2016 were selected and divided into the control group and the observation group by the random number table method.The control group was not given drug analgesia before the end of operation while the observation group was given Flurbiprofen Axetil for analgesia.The mean arterial pressure （MAP），heart rate （HR） and respiratory rate （RR） were compared between the two groups at 5，10，30 min and 60 min in postoperative recovery.The analgesic effects were scored with sedation scoring scale （OAA） and the pain verbal rating scale （VRS）.The adverse reactions in the two groups were recorded.Results There was a statistical significance for VRS，OAA score in the two groups was compared at different time points （P<0.05）.VRS score in the observation group 30 and 60 min after operation was significantly lower than the control group，and OAA score after 5 min and 10 min was significantly lower than the control group，the difference was statistically significant （P<0.05）.Compared with the time point MAP HR，the difference was not statistically significant in the two groups （P>0.05）.RR in the observation group 5，10，30 min after operation were significantly higher than the control group，and the differences were statistically significant （P<0.05）.Conclusion The analgesic effect of Flurbiprofen Axetil is significant after nasal operation.It can effectively relieve postoperative pain and has no obvious inhibition of respiration and blood vessels with high safety.

[Key words]Flurbiprofen Axetil；Nasal operation；Postoperative analgesia

疼痛虽是主观感受，伴随着强烈的情绪色彩，但它的出现通常意味着现在或潜在的组织损伤[1]。鼻部组织病变一般需进行鼻内镜手术治疗，该手术方式可在直视下彻底清除病灶，重建鼻腔结构同时尽可能保留鼻腔正常生理功能及组织结构，但这种手术方式术后疼痛发生率较高，严重影响患者的饮食、呼吸、睡眠等，导致术后恢复较为缓慢，因此充分进行术前、后镇痛既可保证手术顺利进行，也可以减轻患者痛苦、促进术后顺利康复[2]。我院较为常用的镇痛药为氟比洛芬酯，其是一种新型的非甾体类抗炎镇痛药，相对瑞芬太尼，其镇痛时间较为持久，不会出现明显的术后急性疼痛，且可进行靶向镇痛治疗，其术后镇痛疗效明确。本研究以我院60例患者为研究对象进行研究，现报告如下。……