Ye Huijing, Lian Xiufen, Chen Rongxin, Zhu Yanling, Chen Hongbin, Huang Jingxia, Xie Ling, Ma Wenfang, Yang Huasheng, Guo Wenjun
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China,
J Pain Res. 2019 Feb 14;12:659-665. doi: 10.2147/JPR.S187020. eCollection 2019.
This study aimed to investigate postoperative analgesia achieved with intraoperative administration of intravenous flurbiprofen axetil and nalbuphine in patients undergoing orbital decompression.
Sixty-three patients undergoing orbital decompression under general anesthesia at the Zhongshan Ophthalmic Center at Sun Yat-sen University (Guangzhou, China) were randomly allocated into one of the following three groups (1:1:1): intraoperative flurbiprofen axetil 100 mg (Group 1); intraoperative nalbuphine 0.1 mg/kg (Group 2); or intraoperative flurbiprofen axetil 100 mg combined with nalbuphine 0.1 mg/kg (Group 3). The primary end point was mean postoperative pain intensity during the first 24 hours. The secondary efficacy end points were the intensity of pain and discomfort at 0, 2, 6, 10, and 24 hours after surgery and side effects at 24 hours after surgery.
The demographic characteristics were similar among the three groups. Mean and peak postoperative pain scores during the first 24 hours in Group 3 were lower than those in Group 1 (=0.007 and =0.003, respectively) and Group 2 (=0.001 and =0.000, respectively). Additionally, the pain scores in Group 3 were significantly lower than those in Group 1 during the first 6 hours after surgery (=0.003, 0.002, and 0.022 at 0, 2, and 6 hours, respectively) and those in Group 2 during the first 10 hours after surgery (=0.008, 0.000, 0.001, and 0.019 at 0, 2, 6, and 10 hours, respectively). Discomfort scores were not significantly different among the three groups during the observation period, except at 2 hours after surgery, at which time the scores in Group 3 were significantly lower than those in Group 2 (=0.033). Postoperative adverse effects and analgesic requirements were similar among the three groups.
Intraoperative administration of a combination of intravenous flurbiprofen axetil and nalbuphine is superior to single-dose flurbiprofen axetil or nalbuphine in patients undergoing orbital decompression.
本研究旨在调查在接受眼眶减压手术的患者中，术中静脉注射氟比洛芬酯和纳布啡所实现的术后镇痛效果。
中山大学中山眼科中心（中国广州）63例在全身麻醉下接受眼眶减压手术的患者被随机分为以下三组之一（1:1:1）：术中注射氟比洛芬酯100mg（第1组）；术中注射纳布啡0.1mg/kg（第2组）；或术中注射氟比洛芬酯100mg联合纳布啡0.1mg/kg（第3组）。主要终点是术后头24小时内的平均疼痛强度。次要疗效终点是术后0、2、6、10和24小时的疼痛和不适强度以及术后24小时的副作用。
三组患者的人口统计学特征相似。第3组术后头24小时的平均和峰值疼痛评分低于第1组（分别为P=0.007和P=0.003）和第2组（分别为P=0.001和P=0.000）。此外，术后第1组6小时内第3组的疼痛评分显著低于第1组（0、2和6小时时分别为P=0.003、P=0.002和P=0.022），术后第2组10小时内第3组的疼痛评分显著低于第2组（0、2、6和10小时时分别为P=0.008、P=0.000、P=0.001和P=0.019）。在观察期内，三组的不适评分无显著差异，但术后2小时除外，此时第3组的评分显著低于第2组（P=0.033）。三组术后不良反应和镇痛需求相似。
在接受眼眶减压手术的患者中（术中）静脉注射氟比洛芬酯和纳布啡联合用药优于单剂量氟比洛芬酯或纳布啡。
