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右美托咪定联合氟比洛芬酯与舒芬太尼用于结直肠癌患者肿瘤切除术后镇痛的比较:一项前瞻性观察研究。

Comparison of postoperative analgesia between dezocine plus flurbiprofen axetil and sufentanil in patients with CRC undergoing tumor resection: A prospective, observational study.

作者信息

Yang Sufang, Hu Jingchun

机构信息

Department of Anesthesiology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.

出版信息

Oncol Lett. 2025 Jan 7;29(3):121. doi: 10.3892/ol.2025.14869. eCollection 2025 Mar.

Abstract

Flurbiprofen axetil is a nonsteroidal anti-inflammatory drug used for analgesia. Its combination with dezocine has previously shown a superior postoperative analgesic effect compared with that of opioids. The present study compared the analgesic effect between dezocine plus flurbiprofen axetil (DFA) and sufentanil in patients with colorectal cancer (CRC) following resection of the tumor. The study was performed as a prospective, observational study. It included 107 patients who were treated using a patient-controlled analgesia (PCA) pump following the resection of CRC. Patients in the DFA group were given a loading dose of 5 mg dezocine and 50 mg flurbiprofen axetil, followed by PCA with a combination comprising 30 mg dezocine, 200 mg flurbiprofen axetil and 8 mg ondansetron. Patients in the control group were treated with sufentanil at a loading dose of 5-10 µg followed by PCA with a combination of 100 µg sufentanil and 8 mg ondansetron. The DFA group reported lower pain numerical rating scale scores at 2 h (2.4±1.2 vs. 2.9±1.2) and 12 h (2.0±1.0 vs. 2.5±1.2) and reduced rates of moderate-to-severe pain at 12 h (6.7 vs. 21.0%) compared with those in the control group. In addition, the number of PCA boluses in the DFA group was lower than that in the control group [median (interquartile range), 6.0 (4.5-8.5) vs. 8.5 (5.0-11.0)]. The total satisfaction rate was increased, albeit not significantly, in the DFA group compared with that in the control group (80.0 vs. 62.9%). The levels of tumor necrosis factor-α at 24 and 48 h, and of interleukin-6 at 24 h were decreased in the DFA group compared with those in the control group. The incidences of adverse events did not differ between the groups. These findings indicate that DFA provides more effective analgesia, improves patient satisfaction and reduces the levels of pro-inflammatory cytokines with similar adverse effects compared with those of sufentanil in patients after CRC resection.

摘要

氟比洛芬酯是一种用于镇痛的非甾体抗炎药。其与地佐辛联合使用,此前已显示出比阿片类药物更优的术后镇痛效果。本研究比较了地佐辛联合氟比洛芬酯(DFA)与舒芬太尼在结直肠癌(CRC)患者肿瘤切除术后的镇痛效果。该研究作为一项前瞻性观察性研究进行。研究纳入了107例CRC切除术后使用患者自控镇痛(PCA)泵治疗的患者。DFA组患者给予5 mg地佐辛和50 mg氟比洛芬酯的负荷剂量,随后进行PCA,药物组合为30 mg地佐辛、200 mg氟比洛芬酯和8 mg昂丹司琼。对照组患者给予5 - 10 μg的舒芬太尼负荷剂量,随后进行PCA,药物组合为100 μg舒芬太尼和8 mg昂丹司琼。与对照组相比,DFA组在2小时(2.4±1.2 vs. 2.9±1.2)和12小时(2.0±1.0 vs. 2.5±1.2)时疼痛数字评分量表得分更低,且在12小时时中重度疼痛发生率更低(6.7% vs. 21.0%)。此外,DFA组PCA推注次数低于对照组[中位数(四分位间距),6.0(4.5 - 8.5)vs. 8.5(5.0 - 11.0)]。与对照组相比,DFA组的总满意率有所提高,尽管差异不显著(80.0% vs. 62.9%)。与对照组相比,DFA组在24小时和48小时时肿瘤坏死因子-α水平以及在24小时时白细胞介素-6水平降低。两组不良事件发生率无差异。这些研究结果表明,与舒芬太尼相比,DFA在CRC切除术后患者中提供了更有效的镇痛效果,提高了患者满意度,并降低了促炎细胞因子水平,且不良反应相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543a/11726305/6db5def2155d/ol-29-03-14869-g00.jpg

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