氯诺昔康对高龄股骨粗隆间骨折患者超前镇痛效果的临床观察

Clinical observation of preemptive analgesia efficacy of administering lornoxicam on senile patients undergoing femoral intertrochanteric fracture

目的:探讨氯诺昔康对高龄股骨粗隆间骨折患者围手术期超前镇痛的效果及安全性。方法:采用随机对照的试验方法,将48例接受股骨近端髓内钉(PFN)治疗的高龄股骨粗隆间骨折患者分为观察组和对照组,术前24、12h观察组患者口服氯诺昔康8mg,对照组患者口服安慰剂。术后12、24、36、48、72h两组患者均口服氯诺昔康8mg,应用视觉模拟评分(VAS)评价两组术后康复进程中的疼痛差异,患者的镇痛满意度与睡眠满意度,记录额外使用其他镇痛药物的情况和不良反应。结果:观察组术后2、4、8、12、24、48hVAS评分明显低于对照组(P<0.05),镇痛满意度与睡眠满意度明显高于对照组(P<0.01),除对照组中1例有恶心外,无明显不良反应发生。结论:PFN治疗高龄股骨粗隆间骨折围手术期采用氯诺昔康超前镇痛,能有效缓解术后疼痛,改善睡眠状况,无明显不良反应。

Objective：To evaluate the perioperative analgesia efficacy and safety of administering lornoxicam on senile patients undergoing femoral intertrochanteric fracture.Methods：According to the method of randomized controlled trial,48 patients undergoing femoral intertrochanteric fracture were selected and divided into two groups.The treated group was administered lornoxicam at 12,24 h before surgery while the controlled group was admisitering placebo.Both of the two groups were administered lornoxicam at 12,24,36,48,72 h after surgery.VAS score was adopted to measure the postoperative pain extent.At the same time,the analgesic satisfaction score and sleep satisfaction score were investigated.In addition,the side effects of lornoxicam were recorded.Results：From the investigation at 2,4,8,12,24,48 h after surgery,the VAS score was significantly lower in the treated group than that in the control group（P〈0.05）.The analgesic satisfaction score and sleep satisfaction score were significantly higher in the treated group than that in the control group（P〈0.05）.There was no obvious side-effect observed in these two groups except that 1 case felt nousea.Conclusion：Preemptive analgesia of lornoxicam can effectively decrease the postoperative pain extent and improve sleep with no obvious side effect on the senile patients undergoing femoral intertrochanteric fracture.