氯诺昔康超前镇痛在无痛人流术中的应用

The preemptive application of Lornoxicam in painless induced abortion

目的：观察氯诺昔康超前镇痛应用于无痛人流术的临床效果。方法：选择ASAⅠ-Ⅱ级，妊娠4～12周，拟行人流术的患者60例，随机分成氯诺昔康复合异丙酚组（LP组）、芬太尼复合异丙酚组（FP组）及单纯异丙酚组（P组），每组20例。LP组患者术前2h口服氯诺昔康片剂8mg，术中用异丙酚静脉麻醉；FP组麻醉诱导时先缓慢静注芬太尼1μg/kg，4min后开始静注异丙酚；P组单纯使用异丙酚。3组患者异丙酚的诱导量为2mg／kg，术中根据患者的躯体反应必要时追加诱导量的1／3—1／2。观察术前及术中血压（BP）、心率（HR）、脉搏氧饱和度（SPO2）、异丙酚用量、清醒时间、术中肢动情况、术后恶心、呕吐、下腹疼痛程度（采用VAS评分法）。结果：3组术中BP、HR、SPO2术中肢动情况、清醒时间、术后恶心呕吐比较差异无显著性（P〉0．05）；异丙酚用量、术后下腹疼痛程度LP组及FP组明显低于P组（P〈0．05）。结论：氯诺昔康超前镇痛用于无痛人流术，可显著减少异丙酚静脉麻醉的用药量，显著减轻患者术后下腹疼痛程度而不增加不良反应。

Objective： To evaluate the preemptive application effect of Lornoxicam during painless induced abortion. Methods： 60 female patients （ASA Ⅰ - Ⅱ ） undergoing painless abortion were randomized three groups： Lornoxieam plus propofol （group LP, n = 20）, fentanyl plus propofol （ group FP, n = 20） and propofol alone （ group P, n = 20） . Patients in group LP received oral administration lornoxieam 8mg at 2 hours before operation, patients in group FP were received fentanyl 1 μg/kg i v. at 4 min before injected with intravenous propofol. All the patients were given propofol 2 mg/ky to induce general anesthesia, additional dosage of propofol were given 1/3 - 1/2 of induced dosage according to the condition during operation. The blood pressure, heart rate and SPO2 were measured at preoperative and intraoperative. The total dosage of propofol, perceptive time, the movement, postoperative nausea and vomiting were recorded, pain intensity of lower abdominal was assessed using the VAS score. Results： There was no difference in blood pressure, heart rate, SPO2, the movement during operation, and the perceptive time, postoperative nausea and vomiting also were no difference in three groups （ P 〉 0. 05 ）. The group LP and FP showed a significant decrease in the total dosage of propofol and less pain intensity of lower abdominal by VAS compared with group P （P 〈 0. 05） . Conclusion： Lornoxicam plus propofol used in painless induced abortion can significantly decrease the total dosage of propofol and the pain intensity of lower abdominal after operation.