简介：摘要目的研究帕瑞昔布钠、氟比洛芬酯、布托啡诺静脉注射对患者术后镇痛镇静的影响.方法选取全身麻醉１２０例ASAⅠ－Ⅱ级胃癌手术患者.C组帕瑞昔布钠４０mg、P组氟比洛芬酯１００mg、N组布托啡诺２mg、S组芬太尼０．０５mg,分析其对苏醒期的影响.结果术后各时点VSA评分C组、P组、N组均明显低于S组(P＜０．０５);N组在术后１小时内VSA低于P、C组,在２小时后VSA高于P、C组(P＜０．０５);C组在术后VSA６小时后低于P组(P＜０．０５);N组在术后２小时前Ramsay镇静评分高于C组、P组、S组(P＜０．０５),余时间点比较Ramsay差异无统计学意义(P＞０．０５);C组、P组、S组比较Ramsay差异无统计学意义(P＞０．０５);结论布托啡诺、帕瑞昔布钠、氟比洛芬酯均有利于患者苏醒期的过渡,不影响拔管时间、清醒时间,术后不良反应少,均能取得良好的镇痛效果.但三者各有优势,布托啡诺早期镇痛效果好,但嗜睡发生率高;氟比洛芬酯、帕瑞昔布钠镇痛持续时间更长,帕瑞昔布钠尤为突出.临床使用时应结合病情个体化用药.关键词全身麻醉;术后镇痛;帕瑞昔布钠;氟比洛芬酯;布托啡诺AbstractObjectiveTostudytheeffectsoftheintravenousinjectionofParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateonthepostoperaＧtivesedationandanalgesiaofpatients．Approach１２０casesofgeneralanesthesiawerechosen,whowerepatientsofASAⅠ－Ⅱgastriccanceroperation．GroupCParecoxibSodium４０mg,groupPFlurbiprofenaxetil１００mg,groupNButorphanolTartrate２mg,andthecontrolgroupSFentanyl０．０５mgweresetuptoanalyzetheireffectsontherecoveryperiodandrelatedadversereaction．ResultThepostoperativeVSAscoresofgroupC,groupPandgroupNateachtimepointwereobviouslylowerthanthoseofgroupS(P＜０．０５);TheVSAofgroupNwithinthefirsthourafteroperationwaslowerthangroupPandgroupC,whileitwashigherthangroupPandgroupC(P＜０．０５)twohoursaftertheoperation;TheVSAofgroupCwaslowerthangroupP(P＜０．０５)６hoursaftertheoperation;TheRamsaysedationscoreofgroupNwashigherthangroupC,groupPandgroupS(P＜０．０５)inthefirsttwohoursaftertheoperation,andtheRamsaydifferenceshowednosignificanceinothertimepoints(P＞０．０５);ConclusionParecoxibSodium、FlurbiprofenaxetilandButorphanolTartrateareallbeneficialtothetransiＧtionofpatientsinrecoveryperiod．Theydon’taffectbreathingrecoverytime,extubationtimeandwakingtime,causinglesspostoperativeadversereaction,helpＧingtoachieveagoodanalgesiceffect．However,theyhavetheirrespectiveadvantages．ButorphanolTartratehasagoodearlyanalgesiceffect,buttherearehighratesofdrowsiness;ThedurationofanalgesiaofFlurbiprofenaxetilandParecoxibSodiumislong,especiallyParecoxibSodium．Asaresult,theclinicaluseshouldKbeeycwoomrdbsinedwithindividualizedmedicationcondition．Generalanesthesia;Preemptiveanalgesia;Parecoxibsodium;Flurbiprofenaxetil;Butorphanoltartrate中图分类号R６１４文献标识码B文章编号１００１－５３０２(２０１５)０９－０７９１－０２