氟比洛芬酯用于小儿斜视手术的临床研究

目的观察氟比洛芬酯用于小儿斜视手术术后镇痛的有效性和安全性。方法将60例择期行斜视手术的息儿随机分为两组，每组30例。所有患儿均采用丙泊酚、瑞芬太尼靶控输注（TCI）全凭静脉麻醉方法。诱导采用丙泊酚效应室靶浓度为3μg／ml，瑞芬太尼血浆靶控浓度为3ng／ml，达预设浓度后静注维库溴铵0．1mg／kg，气管插管后行机械通气；麻醉维持为丙泊酚2～4μg／ml，瑞芬太尼3～4ng／ml，必要时追加维库溴铵。镇痛组于手术结束前15min缓慢静脉注射氟比洛芬酯1mg／kg（用生理盐水稀释至5m1），对照组于麻醉拔管后缓慢静注生理盐水5ml，两组注射时间均为2rain。记录苏醒时间、拔管时间、恢复室停留时间，观察有无恶心、呕吐、嗜睡、躁动及呼吸抑制等不良反应的发生。观察术后1、2、4、8、12、24h的镇痛评分，同时记录各时点的平均动脉血压、心率、血氧饱和度。结果对照组患儿术后1、2、4、6、8h的MAP、HR值均较镇痛组高（P〈0．05）；两组术后12、24h的MAP、HR值比较差异无统计学意义（P〉0．05）。两组患儿术后各时点Spoz比较差异无统计学意义（P〉0．05）。对照组患儿的苏醒时间和拔管时间均较镇痛组延长（P〈0．05）。但两组患儿恢复室停留时间比较差异无统计学意义（P〉0．05）。对照组患儿术后1、2、4、6、8h的VAS值均较镇痛组高（P〈0．05）；两组术后12、24h的VAS值比较差异无统计学意义（P〉0．05）。对照组患儿术后躁动明显较镇痛组多（P〈0．05）。镇痛组患儿出现恶心、呕吐各1例，而对照组出现恶心2例，呕吐3例，但差异无统计学意义（P〉0．05）。结论氟比洛芬酯起效快，镇痛作用时间长，血流动力学稳定，苏醒期平稳，不抑制中枢，不影响患儿的麻醉苏醒，提高了患儿术后的舒适度。氟比洛芬酯用于小儿斜视手术安全、有效。

The clinical study of postoperative analgesia with flurbiprofen axetil in children undergoing strabismus

Objective To observe analgesic efficacy and safety of flurbiprofen axeil injection in the treatment of postoperative pain in children undergoing strabismus. Methods Sixty children aged from three to seven years old （ASA Ⅰ - Ⅱ ） were randomly assigned into two groups （group Ⅰ and group Ⅱ ）. All children received total intravenous anesthesia （propofol＋Remifentanil,TCI）. In groupⅠ （flurbiprofen group） （n= 30） children received intravenous injection of flurbipmfen axeil 1 mg/kg dosage in 15 minute before operation finished （diluted the drug to 5 ml with normal saline） ; in group Ⅱ （controlled group） received intravenous injection of 5 ml normal saline after removal tracheal catheter. The time of palinesthesia,extubation and detention in recovery room, the incidence rate of complication （nausea and vomiting, drowsiness,restlessness,respiratory depression） after operation, postoperative visual analogue scale （VAS） in 1,2,4,6,8,12 and 24 h after operation were observed. Recorded MAP, HR, SpOz at the same time. Results MAP,HR,VAS in group 11 were significantly higher than those in group Ⅰ in 1,2,4,6 and 8 h after operation（P〈0.05）. The time of palinesthesia and extubation in group Ⅱ were significantly longer than those in group Ⅰ （P〈0.05）. There were no significantly difference in the incidence of complication, detention time in recovery room and SpO2 among two groups （P〉0. 05）. But restlessness in group Ⅱ were significantly higher than those in group I after operation （P〈0.05）. Conclusion Flurbipmfen axeil injection is a safe and effective drug in treatment of postoperative pain in children undergoing strabismus because of rapid onset, longer analgesia, stable vital signs, faster and more stable wake-up, lower side effects.