氯诺昔康围术期镇痛对术后疼痛及应激反应的影响

Pre-emptive analgesia effects of lornoxicam on postoperative pain and stress responses

目的:观察氯诺昔康围术期镇痛对术后病人疼痛及应激反应的影响。方法:60例子宫肌瘤病人于硬膜外麻醉下行经腹子宫次全切除术,随机分为超前镇痛组(A),于手术切皮前30 m in静脉缓慢推注氯诺昔康16 mg:预防性镇痛(B)组,于手术结束关腹时静脉缓慢推注氯诺昔康16 mg;对照组(C)不做任何处理。术后不同时间点观察视觉模拟评分(VAS),并分别于术晨、术后0、3、12、24 h抽血检测病人血糖、血皮质醇、胰高血糖素水平。结果:A组与B组均能在术后12 h内产生良好的镇痛效果,A组在术后2、4、12 h VAS评分显著低于B组(P<0.05)。A组能够有效地抑制应激激素的分泌,并在抑制术后高血糖反应上优于B组、C组。结论:氯诺昔康行超前镇痛,可有效缓解子宫次全切除术后病人腹部疼痛,抑制病人术后的应激反应。

Objective： To study the pre -eruptive analgesia effects of lornoxicam on postoporative pain and stress responses. Methods： Sixty ASA Ⅰ-Ⅱ patients with hysteromyoma undergoing selective hysteromyomectomy were randomly divided into three groups （n = 20） ： goup A, received lornoxicam 16 mg 30 minutes before skin cutting; group B, received lornoxicam 16 mg at the end of operation; group C, control group without pre -eruptive analgesia. The VAS and the levels of bllood glucose, cortisol and glucagon were measured at various times. Results： The VAS in group A was significantly lower than that in group B at 2, 4 and 12 h postoperatively （P 〈0. 05）. In group A, the levels of postopomtive blood glucose, cortisol and glucagon were significantly lower than those in group B and group C. Conclusion： The pre - eruptive analgesia with lornoxicam could provide effective postoperative pain relief for patients undergoing hysteromyomectomy, and induce notable remission of the stress reaction of the patients in the perioperative period.