三种不同浓度的氯诺昔康和吗啡用于静脉镇痛的比较

Comparison of PCIA with different concentration of lornoxicam and morphine in orthopedic patients

目的 探讨氯诺昔康在病人自控静脉镇痛 (PCIA)的临床应用。方法 选择骨科手术病人 12 0例 ,随机分成四组 ,每组 30例。L1组 ,0 0 2 4 %氯诺昔康 +0 0 1%氟哌利多 ;L2 组 ,0 0 32 %氯诺昔康 +0 0 1%氟哌利多 ;L3 组 ,0 0 4 0 %氯诺昔康 +0 0 1%氟哌利多 ;M组 ,0 0 5 %吗啡+0 0 1%氟哌利多。应用PCA泵LCP给药模式设置 :总量 15 0ml,负荷量 5ml,背景输注 2ml/h ,PCA 1ml,锁定时间 10min。手术后感觉疼痛明显时 (VAS 5 0mm左右 )启动PCA泵。观察PCIA开始、2、4、8、12、16、2 4、36、4 8h各时间点的镇痛效果和不良反应。结果 镇痛效果L1组较M组差 ,L2组与M组相当 ,L3 组优于M组 (P <0 0 5 )。L1、L2 、L3 组间不良反应无显著性差异 ,仅个别出现轻微的恶心呕吐反应 ,且明显少于M组 (P <0 0 1)。结论 0 0 4 %的氯诺昔康为合适镇痛浓度 。

Objective To compare pattient controlled intravenous analgesia(PCIA) with different concentration of lornoxicam and morphine in patients after orthopedic operations. Methods One hundred and twenty patients after orthopedic operations were randomly divided into four groups with 30 cases each. The patients in group L 1 received 0.024% lornoxicam plus 0.01% droperidol,in group L 2 0.032% lornoxicam plus 0.01% droperidol,in group L 3 0.040%lornoxicam plus 0.01% droperidol and in group M 0.05% morphine plus 0.01% droperidol. PCIA parameters were a loading dose of 5 ml,a bolus dose of 1 ml,lockout interval of 10 minutes and continuous infusion of 2 ml/h. Visual analogue scales (VAS) and adverse effects were observed at 2,4,8,12,16,24,36 h and 48 h postoperatively. Results Pain score was higher in group L 1 than that in group M,was not significantly different between group L 2 and group M. Pain score was lower in group L 3 than that in group M(P<0.05).Lornxicam caused fewer adverse effects such as nausea and vomiting than morphine. Conclusion PCIA with 0.040% lornoxicam can provide a good postoperative analgesia and use safely in orthopedic surgical patients.