氯诺昔康联合吗啡用于全麻乳癌根治术后自控镇痛的研究

Effects of lornoxicam plus morphine for patient controlled analgesia after radical operation of mastocarcinoma

目的:观察氯诺昔康联合吗啡用于全麻乳癌根治术后自控镇痛的效果及安全性。方法:限期乳癌根治术患者40例,随机分为氯诺昔康组(L组)和曲马多组(T组),每组20例。L组:氯诺昔康40mg+吗啡10mg;T组:曲马多800mg+氟哌啶5mg,将以上药液加生理盐水至100ml。术毕前30min静注相应负荷药液后开始静脉镇痛治疗,采用持续背景剂量(2ml/h)配合单次按压剂量(1ml),锁定时间30min。采用视觉模拟评分(VAS)及镇静度评分,记录每个患者术后的疼痛和镇静程度及不良反应。结果:两组术后VAS疼痛评分无显著性差异(P>0·05);镇静度评分:12h以后T组高于L组(P<0·05);不良反应发生率L组低于T组(P<0·05)。结论:氯诺昔康联合吗啡用于全麻乳癌根治术后自控镇痛安全有效,满意度优于曲马多,副作用轻。

Objective： To evaluate efficacy and safety of lornoxicam plus morphine for patient controlled analgesia （PCA） after radical operation of mastocarcinoma under general anesthesia. Methods： 40 patients underwent radical operation of mastocarcinoma were randomized to intravenously administrate either lornoxicam 8 mg or tramal 100 mg at 30 min before surgical closure and then immediately receive one of the postoperative patient controlled analgesic regimens for 48 hours： Lornoxicam 40 mg plus morphine 10 mg （group L） or tramal 800 mg plus droperidol 5 mg （group T）, which were diluted NS to 100 ml. The VAS, Ramsay scale and the inceidence of adverse events were used to evaluate the analgesic response and safety profiles. Results： No significant difference in VAS evaluation was showed in the two analgesic groups （P 〉 0. 05 ） . Patients in group T experienced more sedation than those in group L at 12 hours post surgery （P 〈 0. 05 ） The incidence of adverse events in group L was fewer than those in group T （ P 〈 0. 05 ） . Conclusion ： Lornoxicam plus morphine was superior to tramal in patient controlled analgesia after radical operation of mastocarcinoma.