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成人扁桃体切除术后预防疼痛的术前氟比洛芬应用

Preoperative flurbiprofen for pain prevention after tonsillectomy in adults.

作者信息

Nishiike Suetaka, Kato Takashi, Nagai Miki, Nakagawa Aya, Konishi Masaki, Sakata Yoshiharu, Shimada Fumihiko, Kida Hideki, Ota Masato, Harada Tamotsu

机构信息

Department of Otolaryngology, Kawasaki Medical School, Kurashiki, Okayama 701-0192, Japan.

出版信息

J Clin Anesth. 2007 Dec;19(8):596-600. doi: 10.1016/j.jclinane.2007.06.015.

Abstract

STUDY OBJECTIVE

To investigate the analgesic efficacy of preoperative flurbiprofen on postoperative pain after tonsillectomy.

DESIGN

Prospective, randomized, nonblinded, non-placebo-controlled study.

SETTING

Municipal hospital.

PATIENTS

Twenty-five ASA physical status I patients older than 20 years of age, who were scheduled for tonsillectomy.

INTERVENTIONS

Patients were randomly allocated to two groups to receive preoperative intravenous (IV) 50 mg flurbiprofen (group F) or not (group C). Anesthesia was induced with IV propofol two mg/kg and maintained with nitrous oxide and sevoflurane.

MEASUREMENTS

Pain scores at rest and at swallowing, intraoperative bleeding, vital signs during the postanesthetic period, interval until diclofenac sodium suppository rescue, and the total dose required for 12 hours postoperatively were all recorded.

MAIN RESULTS

Pain scores at rest as well as those recorded after swallowing 30 minutes after tonsillectomy were significantly lower in group F than in group C. During the first postoperative 1.5 hours, significantly fewer patients in group F required rescue diclofenac suppository than did group C patients. However, total dose of required rescue during the postoperative 12 hours in group F did not significantly differ from that of group C. There were no significant differences in intraoperative bleeding or in any vital signs during the postanesthetic period either.

CONCLUSION

Preoperative flurbiprofen suppressed immediate postoperative pain after tonsillectomy. The analgesic effect, however, disappeared in a few hours and was insufficient for overnight pain relief.

摘要

研究目的

探讨术前氟比洛芬对扁桃体切除术后疼痛的镇痛效果。

设计

前瞻性、随机、非盲、非安慰剂对照研究。

地点

市立医院。

患者

25例年龄大于20岁、美国麻醉医师协会(ASA)身体状况I级、计划行扁桃体切除术的患者。

干预措施

患者被随机分为两组,一组术前静脉注射(IV)50mg氟比洛芬(F组),另一组不注射(C组)。静脉注射丙泊酚2mg/kg诱导麻醉,并用氧化亚氮和七氟醚维持麻醉。

测量指标

记录静息和吞咽时的疼痛评分、术中出血量、麻醉后时期的生命体征、至双氯芬酸钠栓剂解救的间隔时间以及术后12小时所需的总剂量。

主要结果

F组扁桃体切除术后30分钟静息时以及吞咽后的疼痛评分均显著低于C组。术后1.5小时内,F组需要双氯芬酸栓剂解救的患者明显少于C组。然而,F组术后12小时所需解救的总剂量与C组无显著差异。术中出血量及麻醉后时期的任何生命体征也无显著差异。

结论

术前氟比洛芬可抑制扁桃体切除术后的即刻疼痛。然而,镇痛效果在数小时内消失,不足以缓解夜间疼痛。

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