【摘要】：目的：探討術(shù)中靜脈注射芬太尼復(fù)合氟比洛芬酯對(duì)乳腺癌根治術(shù)患者術(shù)后疼痛的影響。 方法：采用隨機(jī)、雙盲、對(duì)照的研究方法,將60例行乳腺癌根治術(shù)的患者分成3組：芬太尼組(F組)、芬太尼復(fù)合氟比洛芬酯組(KF組)和對(duì)照組(N組),每組20例。所有患者均采用氣管內(nèi)插管全身麻醉。在常規(guī)麻醉的基礎(chǔ)上,F組患者切皮后45min靜脈注射芬太尼2.0μg/kg；KF組患者切皮前10min和手術(shù)結(jié)束即刻分別予氟比洛芬酯1mg/kg,并于切皮后45min靜注芬太尼2.0μg/kg；N組患者不做特殊處理。用疼痛視覺模擬評(píng)分法(VAS評(píng)分)雙盲評(píng)估患者術(shù)后拔管即刻、3h、6h、12h、第1天、第2天、第3天、第7天的疼痛程度,觀察術(shù)后48h內(nèi)其他鎮(zhèn)痛藥的使用情況以及術(shù)后惡心嘔吐、呼吸抑制等相關(guān)的不良反應(yīng)的發(fā)生率。 結(jié)果：三組患者年齡、身高、體重、臨床病理特征等情況的比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。KF組患者術(shù)后拔管即刻、3h、6h、12h、第1天、第2天的VAS評(píng)分均比F組和N組患者低(P0.05)；F組患者術(shù)后拔管即刻VAS評(píng)分低于N組(P0.05),而術(shù)后3h、6h、12h、第1天、第2天F組和N組患者VAS評(píng)分比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)；術(shù)后第3天、第7天三組患者的VAS評(píng)分比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)；三組患者術(shù)后48h鎮(zhèn)痛藥用量以及不良反應(yīng)發(fā)生率的比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論：術(shù)中靜脈注射芬太尼復(fù)合氟比洛芬酯可減輕乳腺癌根治術(shù)患者的術(shù)后早期疼痛,且不增加不良反應(yīng)的發(fā)生率。
[Abstract]:Objective: to investigate the effect of intraoperative intravenous fentanyl combined with flurbiprofen ester on postoperative pain in patients with breast cancer. Methods: 60 patients undergoing radical mastectomy were randomly divided into three groups: fentanyl group (group F), fentanyl combined with flurbiprofen group (group KF) and control group (group N). All patients were anesthetized by endotracheal intubation. On the basis of routine anesthesia, the patients in group F were given flurbiprofen 1 mg / kg before skin incision and immediately after operation by intravenous 45min injection of fentanyl 2.0 渭 g / kg 路kg ~ (-1) after skin incision, and the patients in group N received intravenous fentanyl 2.0 渭 g 路kg ~ (-1) / kg of fentanyl intravenously after incision, and no special treatment was given to the patients in the group of Fentanyl 2.0 渭 g / kg of fentanyl. Pain visual analogue score (VAS) was used to evaluate the degree of pain in patients with postoperative pain after extubation for 6 h or 12 h, day 1, day 2, day 3, day 7, and to observe the use of other analgesics within 48 hours after operation and postoperative nausea and vomiting. Incidence of related adverse reactions such as respiratory suppression. Results: there was no significant difference in age, height, weight and clinicopathological features among the three groups (P0.05). The VAS scores of the patients in KF group were lower than those in group F and group N (P0.05). The VAS score of group F was lower than that of group N immediately after extubation (P0.05), but there was no significant difference in VAS score between group F and group N on day 1, day 2, day 1, day 2 (P0.05), VAS score of group 3 and day 7 after operation was higher than that of group N (P0.05). The difference was not statistically significant (P0.05); there was no significant difference between the three groups in the dosage of analgesics and the incidence of adverse reactions 48 hours after operation (P0.05). Conclusion: intraoperative intravenous injection of fentanyl combined with flurbiprofen ester can relieve early postoperative pain in patients with breast cancer, and does not increase the incidence of adverse reactions.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

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