氯诺昔康用于术毕镇痛的效果分析

The analgesia effect of lornoxicam on postoperative patients

目的观察氯诺昔康于开胸术毕加强镇痛的疗效。方法选择40例单纯全麻开胸患者随机分为两组,麻醉前及关胸时静脉用药,Ⅰ组(n=20)静注氯诺昔康8mg,Ⅱ组(n=20)静注0.9%氯化钠2ml。观察指标为躁动评分、Ramsay镇静评分、BCS舒适评分、心率、平均动脉压及不良反应。观察时间点为:麻醉前、术毕清醒时、气管拔管时、拔管后5min和10min。结果与麻醉前各值比较,拔管时心率、平均动脉压各组明显升高(P<0.05),5min后恢复到麻醉前水平;术毕清醒时、拔管后10min,Ⅰ组与Ⅱ组相比,躁动显著减少(P<0.05);Ⅰ组与Ⅱ组相比,镇静差异无显著性(P>0.05);Ⅰ组比Ⅱ组舒适(P<0.05);两组都无明显恶心、呕吐。结论氯诺昔康可加强单纯全麻开胸术毕苏醒期患者镇痛,防治苏醒期躁动。

Obiective To assess the analgesia effect of lornoxicam at postoperative thoracic surgery. Methods 40 patients underwent thoracic surgery and general anesthesia were randomly divided into two groups. Patients in Group Ⅰ （n=20） were intravenously injected with lornoxicam 8 mg and Group Ⅱ （n=20） with normal saline 2ml before anesthesia and closing thoracic cavity. The effectiveness was assessed with restlessness score, Ramsay sedation scale, bruggrmann comfort scale at the time of pre-anesthesia, the moment of recovery from operation immediately after tracheal extubation, 5 and 10 minutes after tracheal extubation. HR and MAP were simultaneously monitored and the adverse effects were observed. Results HR and MAP showed a significant increase at tracheal extubation as compared with the baseline levels （P〈0.05） and achieved the baseline levels in 5 minutes ; Patients in Group Ⅰ experienced less restlessness score than patients in Group Ⅱ in the moment of recovery postoperation and 10 minutes after tracheal extubetion（p〈0.05） ; No statistical difference in the sedation effectiveness between two groups was observed（p〉0.05） ; Patients in Group Ⅰ had higher comfortable score as compared with those in Group Ⅱ （p〈0.05） ; No nausea and vomiting were reported in two groups. Conclusion Lornoxicam can increase the effect of analgesia in patients undergone thoracic surgery in the period of recovery from general anesthesia and prevent the occurrence of restlessness.