探讨氟比洛芬酯（凯芬）抑制瑞芬太尼致患者术后痛觉过敏反应的量效关系。

选择我院2010年1至6月期间，择期全麻下腹部大手术患者50例，静脉注射咪达唑仑、芬太尼、丙泊酚和顺阿曲库铵麻醉诱导后，气管插管后行静脉麻醉。术中静脉输注0.25 μg·kg^-1·min^-1瑞芬太尼和3~4 mg·kg^-1·h^-1丙泊酚，间断静脉注射顺阿曲库铵维持麻醉。麻醉诱导后，采用序贯法静脉注射氟比洛芬酯，初始剂量为1 mg/kg，相邻梯度为0.2 mg/kg。采用概率单位分析法计算氟比洛芬酯抑制瑞芬太尼术后痛觉过敏的量效关系：半数有效剂量（ED50）、95%有效剂量（ED95）及其95%可信区间。

氟比洛芬酯抑制瑞芬太尼致患者术后痛觉过敏的ED50为1.40（95% CI=1.13~1.61）mg/kg，ED95为2.21（95% CI=1.89~3.33）mg/kg。

氟比洛芬酯抑制瑞芬太尼致术后痛觉过敏的ED50和ED95分别为1.40 mg/kg和2.21 mg/kg。

To investigate the dose-response relationship of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia in patients undergoing major abdominal surgery.

Fifty patients undergoing major abdominal surgery under remifentanil-based general anesthesia were studied. Anesthesia was induced with midazolam 0.05 mg/kg, propofol 2 mg/kg, fentanyl 4 μg/kg and cisatracurium 1 mg/kg and maintained with infusion of remifentail(0.25 μg·kg^-1·min^-1) and propofol(3-4 mg·kg^-1·h^-1). Cisatracurium was given intermittently. The patients were mechanically ventilated after tracheal intubation. Flurbiprofen was given before skin incision for inhibiting remifentanil-induced postoperative hyperalgesia. Pain was assessed using VAS at 10 min after tracheal extubation. VAS score <4 was defined as effective. The optimal dose was determined by Dixon’s up-and-down method. If the VAS score was<4, the next patient received a lower dose of flurbiprofen, or conversely if ineffective, a high dose was given in the next patient. The up-and-down sequences were analyzed by using probit method that determine the ED50, ED95 and 95% confidence interval(CI).

The ED50 and ED95 of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia in patients following gynecological laparoscopy were 1.40(95% CI=1.13- 1.61)mg/kg and 2.21(95% CI=1.89-3.33)mg/kg.

The ED50 and ED95 of flurbiprofen for inhibiting postoperative hyperalgesia after remifentanil-based anesthesia in patients following major abdominal surgery are 1.40 mg/kg and 2.21 mg/kg respectively.