氯诺昔康对芬太尼致术后吗啡用量增加的预防作用

Preventive effect of lornoxicam on fentanyl-induced increase of morphine requirement for postoperative analgesia

目的探讨氯诺昔康是否可以预防芬太尼致术后吗啡用量增加。方法60例拟在腰麻下行开腹全子宫切除术的患者随机分为芬太尼组(F组)、氯诺昔康组(L组)、芬太尼加氯诺昔康组(FL组)及对照组(C组),分别给予芬太尼1μg/kg×3次、氯诺昔康8mg、芬太尼1μg/kg×3次加氯诺昔康8mg及生理盐水。结果术后3、6及12hF组患者的累计吗啡用量显著高于L、FL、C组(P<0.05)。L组、FL组及C组患者在术后各时间点的累计吗啡用量差异无统计学意义。各组患者在术后各时间点的VAS及药物副作用发生率差异无统计学意义。结论术中应用芬太尼可导致术后吗啡用量增加。在使用芬太尼之前预先给予氯诺昔康可预防芬太尼导致的术后吗啡用量增加。

Objective To investigate if co-administration of lornoxicam and fentanyl could prevent the increase of postoperative morphine requirement induced by fentanyl. Methods Sixty female patients undergoing total abdominal hysterectomy under spinal anaesthesia were randomly assigned to 4 groups of fentanyl （3 bolus injections of 1μg/kg,group F ）, lornoxicam （one bolus of 8 mg, group L）, and lornoxicam plus fentanyl （one bolus of 8 mg lornoxicam plus 3 bolus of 1 μg/kg fentanyl, group FL）and normal saline（group C）. Results Cumulative morphine consumption in group F was significantly more than that in group C at 3, 6, 12 h after operation （P〈0.05）. The postoperative cumulative morphine consumption was similar in groups L, FL and C. No differences in postoperative pain scores and side effects were observed among the groups. Conclusion The .data suggest that the increase of postoperative morphine requirements induced by intraoperative administration of fentanyl could be prevented by pretreatment with lornoxicam.