氯诺昔康联合芬太尼术后镇痛的临床试验

Evaluation of Lornoxicam Combined with Fentanyl for Postoperative Analgesia in Patients

目的:探讨氯诺昔康合理的临床应用方法。方法:将60例接受单纯全麻的开胸、胸椎、腰椎手术患者分为2组,Ⅰ组患者全麻诱导后术中不再使用其他静脉镇痛药物,Ⅱ组患者麻醉前静脉注射氯诺昔康8 mg,如手术时间超过4 h,则术中追加氯诺昔康4 mg,所有患者术毕即开始PCIA,观察术毕清醒、术后12 h、24 h、48 h的VAS评分、血压、心率及脉搏血氧饱合度(SPO_2),和术后48 h的镇痛药总用量、患者按压(bolus)的总次数与实际进药次数,两者之间的比值(即D/D比值),记录患者对镇痛效果的满意度。结果:Ⅱ组在术中静脉注射和术后PCIA泵中加入氯诺昔康,可显著降低术后VAS评分,减少患者主动按压的次数、D/D值以及对阿片类药物(芬太尼)的需求量。结论:氯诺昔康在PCIA中作为基础镇痛药用于术后镇痛,可显著提高镇痛效果,减少阿片类药物(芬太尼)的需求量。

Objective： To investigate the preemptive analgesic effect of intravenous lomoxicam. Method： 60 patients undergoing general anesthesia were divided into two groups. Group Ⅰ was administered only fentanyl （5 μg· ml^-1 ） while Group Ⅱ was administered fentanyl （5 μg· ml^-1 ） and lomoxicam（0.16 mg· ml^-1）. The effectiveness was postoperatively assessed by the visual analogue scale （VAS） （at rest） at 12, 24, 48 hours after surgery and by calculating the total analgesic consumption of fentanyl and the demand/delivery （D/D） of PCIA in the first 48h following the operations. Result：Lomoxicam could significantly reduce VAS at 12, 24, 48 hours after surgery, the total analgesic consumption of fentanyl and the D/D of PCIA in the first 48 h following the operations. Conclusion： Lomoxicam has a preemptive analgesic effect. Administered preemptively as opioid analgesics, lornoxicam appears to improve the quality of postoperative analgesia.