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氟比洛芬酯复合利多卡因局麻在骨牵引术中的应用
作者:郭玉冬  王宸  石柳  沈剑粦  曾令斌 
单位:东南大学附属中大医院 骨科, 江苏 南京 210009
关键词:氟比洛芬酯 骨牵引术 镇痛 
分类号:R683.4
出版年·卷·期(页码):2013·32·第五期(580-583)
摘要:

目的:探讨术前静脉滴注氟比洛芬酯(flurbiprofen)复合利多卡因局部麻醉在骨牵引术中疼痛控制效果。方法:将急诊收治的24例行股骨髁上牵引或胫骨结节牵引患者随机分为利多卡因组(利多卡因组)和利多卡因局麻+氟比洛芬酯组(复合麻醉组),每组12例。利多卡因组术前30 min静脉滴注脂肪乳100 ml,在骨牵引时行利多卡因局部浸润麻醉;复合麻醉组术前30 min静脉滴注氟比洛芬酯50 mg(100 ml),骨牵引时行利多卡因局部浸润麻醉。观察两组患者术前、术中及术后疼痛视觉模拟量表(visual analogue scale, VAS)评分、术后镇痛药物最早使用时间及24 h镇痛药物使用量。结果:复合麻醉组患者术中、术后均获得较满意的镇痛效果,术后首次使用镇痛药物时间为(16.75±2.19) h,较利多卡因组[(8.97±2.24) h]延迟,24 h内阿片类镇痛药物使用明显减少(P=0.003)。两组术中及术后均未出现明显的不良反应。 结论:术前氟比洛芬酯静脉滴注复合利多卡因局部麻醉可有效地缓解患者骨牵引术中及术后疼痛,减少阿片类药物使用量。

Objective: To observe the analgesic effect of preoperative intravenous flurbiprofen combined lidocaine local infiltration anesthesia in the skeletal traction. Methods: Twenty-four patients who underwent a femoral supracondylar skeletal traction or tibial tubercular skeletal traction were randomized into two groups(12 patients in each). Lidocaine Group received intravenously fat emulsion injection 100 ml at 30 min before skeletal traction, and combined anaetheia group received intravenously 50 mg flurbiprofen (100 ml) at 30 min before skeletal traction. Postoperative analgesia was supplied with intramuscular 50 mg pethidine according to the patient's demand. Visual analog scale (VAS) score at preoperation, operation time, postoperation were measured and the earliest time of postoperative analgesic and amount of analgesics in 24 h after the operation were recorded. Results: VAS in combined anaetheia group was significantly lower than that in Lidocaine group during the intraoperative and postoperative time(all P<0.01). The amount of pethidine consumption in combined anaetheia group was also significantly (P=0.035) less than that in Lidocaine group within the first 24 h postoperatively. The earliest time of postoperative analgesic in combined anaetheia group was(16.75±2.19) h, and longer than that in Lidocaine group[(8.97±2.24) h].Amount of analgesics in 24 h after the operation was significantly reduced (P=0.003). Conclusion: Preoperative intravenous flubiprofen combined local infiltration anesthesia can effectively reduce the patients' pain within the intraoperative and postoperative time,and reduce the amount of opioid analgesics consumption.

参考文献:

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