Abstract: Objective: To observe the effects of hydromorphone combined with flurbiprofen for postoperative analgesia in orthopedic lower extremity surgery. Methods: 90 cases of orthopedic lower extremity surgery patients were randomly divided into SF group, K group and KH group with 30 patients in each group. The patients in 3 groups used sufentanil (SF group: 2μg/kg~3μg/kg), hydromorphone (K group: 0.12mg/kg~0.14mg/kg) and hydromorphone+flurbiprofen (KH group: 0.12mg/kg+50mg) for postoperative analgesia respectively. The press times of patient-controlled intravenous analgesia (PCIA), VAS score and Ramsay score (2h, 6h, 12h, 24h after operation), as well as adverse reactions (skin itch, drowsiness, dizziness, nausea and vomiting, respiratory depression) of patients in 3 groups were compared. Results: The VAS score at each time point after operation, the press times of PCIA, adverse reactions rate of patients in KH group were all obviously lower than SF group and K group (P<0.05). There was no significant difference about the Ramsay score at each time point after operation of the 3 groups (P>0.05). Conclusions: Hydromorphone combined with flurbiprofen for postoperative analgesia in orthopedic lower extremity surgery is a safe and effective postoperative analgesic method, which can obtain better analgesic effects and less adverse reactions.

Key words: Orthopaedic surgey, Hydromorphone, Flurbiprofen, Patient-controlled intravenous analgesia

摘要： 目的: 观察氢吗啡酮复合氟比洛芬酯用于骨科下肢手术术后镇痛的效果。方法: 90例骨科下肢手术患者随机分为SF组、H组和KH组,每组30例,三组患者术后分别应用舒芬太尼（2μg/kg~3μg/kg）、氢吗啡酮（0.12mg/kg~0.14mg/kg）和氢吗啡酮复合氟比洛芬酯（0.12mg/kg+50mg）静脉自控镇痛。记录三组患者镇痛泵（PCIA）按压次数,术后2h、6h、12h、24h的VAS疼痛评分和Ramsay镇静评分;以及皮肤瘙痒、嗜睡、眩晕、恶心呕吐、呼吸抑制等不良反应发生情况。结果: KH组患者术后各时间点VAS评分、PCIA按压次数、不良反应发生率均明显低于SF组和H组（P<0.05）;三组患者术后各时间点Ramsay镇静评分比较,差异无统计学意义（P>0.05）。结论: 氢吗啡酮复合氟比洛芬酯用于骨科下肢手术术后镇痛效果好且不良反应少,是一种安全有效的术后镇痛方法。

关键词: 骨科手术, 氢吗啡酮, 氟比洛芬酯, 静脉自控镇痛