氯诺昔康超前镇痛在电视胸腔镜手术中的应用

Application of advance analgesia using lornoxicam in video-assisted thoracoscope surgery

目的：观察氯诺昔康超前镇痛对电视胸腔镜下肺大泡切除术术后镇痛效应的影响。方法：选择60例ASAⅠ~Ⅱ级拟在全身麻醉下行电视胸腔镜下肺大泡切除术的患者,随机分为氯诺昔康组（L）组30例;安慰剂组（C）组30例。分别于手术切皮前给予氯诺昔康16 mg/10 mL和安慰剂（生理盐水10mL）静脉注射。患者术中均采用异丙酚、瑞芬太尼全凭静脉麻醉。并用VAS评分法进行术后镇痛评估,记录术后镇痛药的总用量,观察不良反应。结果：两组术毕、术后1、12、16、24、36、48 h的VAS评分差异无统计学意义（P〉0.05）。但L组术后2、4、81、0 h VAS评分显著低于C组（P〈0.01）;L组48h芬太尼的用量及不良反应均低于C组（P均〈0.05）。结论：氯诺昔康超前镇痛能明显减轻电视胸腔镜手术患者的术后疼痛,并能减少阿片类镇痛药的用量及不良反应。

Objective： To observe the postoperative analgesia effects of lornoxicam in video-assisted thoracoscope surgery.Methods： A total of 60 cases of ASAⅠ-Ⅱscheduled for video-assisted thoracoscope surgery were randomly divided into lornoxicam group（group L,30 cases） and placebo group（group C,30 cases）,and were given preoperative lornoxicam 16 mg /10 mL and physiological saline 10 mL via intravenous application respectively.During the surgery procedure,propofol,and rachel fentanyl were used for intravenous anesthesia.VAS for postoperative analgesia evaluation and total amount of propofol,and rachel fentanyl,as well as side effects of the two groups were recorded and compared.Results： No significant difference in VAS of the two groups at 1,12,16,24,36,48 h after the operation were found（P0.05）,but at 2,4,8,10 h after the procedure,significant difference in VAS were presented（P all 0.01）.Besides,group L showed less consumption of rachel fentanyl and less side effects（P both 0.05）.Conclusions： Lornoxicam can relive postoperative pain in video-assisted thoracoscope surgery,decrease side effects as well as consumption of pain killer.