氯诺昔康在鼻内镜手术后患者自控静脉镇痛中的疗效观察

The effect of lornoxicam controlled intravenous analgesia after functional endoscopic sinus surgery

目的观察氯诺昔康用于鼻内镜手术后患者自控静脉镇痛（PCIA）的临床效果和安全性。方法74例拟行全身麻醉下鼻内镜手术患者完全随机分为试验组和对照组，每组37例。试验组予氯诺昔康行PCIA，对照组予芬太尼行PCIA。分别记录2组患者术后2、4、8、24、32h的疼痛视觉模拟评分（VAS）、警觉／镇静评分（OAA／S）和血氧饱和度（SpO2），并记录PCIA期间2组患者不良反应发生率。结果手术后各时间点2组患者VAS评分均在3分以下，组间差异无统计学意义，P〉0．05。各时间点OAA／S评分和SpO2，试验组均高于对照组，P〈0．05。试验组不良反应总发生率13．5％（5例）显著低于对照组45．9％（17例），P〈0．05。结论氯诺昔康用于鼻内镜手术后PcIA镇痛效果确切，对患者意识水平和呼吸影响小，不良反应发生率低。

Objective To evaluate the clinic efficacy and safety of lomoxicam for patient controlled intrave- nous analgesia after functional endoscopic sinus surgery. Methods Seventy-four patients undergoing functional en- doscopic sinus surgery under general anesthesia were randomly divided into experimental group and control group, with 37 cases in each group. Lomoxicam was administered in experimental group and fentanyl was applied in control group. The visual analogue scale （VAS） score, OAA/S （observer assessment alertness/sedation） score and SpO2 were recorded at 2, 4, 8, 24 and 32 hours after the operation respectively. The adverse reactions were also recor- ded. Results The VAS scores at each timepoint in both groups were all not more than 3 and there was no signifi- candy difference between the two groups （P 〉 0.05）. The OAA/S score and SpO2 in each timepoint were higher in experimental group than those in control group （P 〈 0.05 ）. The incidence of adverse reactions was significantly low- er in experimental group than that in control group （P 〈 0.05）. Conclusion Patient controlled intravenous analgesia （PCIA）with lornoxicam can provide efficient and safe postoperative analgesia for patients of functional endoscopic sinus surgery relatively with few influence on the level of consciousness and respiration.