舒芬太尼复合氯诺昔康用于脊柱手术后静脉自控镇痛的临床观察

Clinical observation on effect of Lornoxicam as supplement to Sufentanil in patient-controlled intravenous analgesia after spine surgery

目的:观察舒芬太尼复合氯诺昔康用于脊柱手术后病人自控静脉镇痛的效果和不良反应。方法:选择择期脊柱手术后行自控静脉镇痛的患者60例,随机分为2组:Ⅰ组为舒芬太尼组,Ⅱ组为氯舒组。Ⅰ组术后镇痛给予舒芬太尼1μg.mL-1+托脘司琼0.05mg.mL-1;Ⅱ组手术结束前30min给予氯诺昔康8mg,术后镇痛给予舒芬太尼0.7μg.mL-1+氯诺昔康0.4mg.mL-1+托脘司琼0.05mg.mL-1。两组病人自控静脉镇痛泵的设置:背景剂量为2mL.h-1,自控静脉镇痛剂量为每次0.5mL,锁定时间15min。观察并记录两组患者术后2h、4h、8h、16h、24h、48h的镇痛、镇静评分及不良反应的发生情况。结果:Ⅱ组术后镇痛及镇静评分低于Ⅰ组,两组不良反应发生率的差异无统计学意义。结论:舒芬太尼复合氯诺昔康用于脊柱手术后静脉自控镇痛的效果优于舒芬太尼。

Objective：To observe the effect and adverse reaction of lornoxicam as supplement to sufentanil in patient-controlled intravenous analgesia （PCIA）after spine surgery. Methods：60 patients subjected to controlled intravenous analgesia after selective spine surgery were randomly divided into sufentanil group（ group Ⅰ ）and lornoxicam group（ group Ⅱ ）. Patients in Group I were administrated with 1μg · mL^- 1 sufentanil and 0.05mg · mL^-1 tropisetron for postoperative analgesia,while those in group Ⅱ were administrated with 8 mg lornoxicam 30 minutes before the end of the surgery and 0.7μg · mL-l sufentanil,0.4mg · mL^-1 lornoxicam and 0.05 mg · mL^-1 tropisetron for postoperative analgesia. PCIA pumps of 2 groups were designed for maintaining 2 mL · h basal infusion with 0.5mL PCIA dose every time for 15 minutes. The scores of analgesia and sedation and the incidence of adverse reaction at the time points of 2 h,4 h,8 h, 16 h,24 h,48 h after the surgery were observed and recorded. Results： Scores of postoperative analgesia and sedation of group Ⅱ was lower that of group Ⅰ.There was no statistical difference in the incidence of adverse reactions between the two groups. Conclusion： The effect of lornoxicam as supplement to sufentanil is better than that of sufentanil in patient-controlled intravenous analgesia after spine surgery.