氯诺昔康复合舒芬太尼用于妇科术后镇痛的临床观察

Clinical observation of lornoxicam combined with sufentanil for analgesia after gynecological surgery

目的观察氯诺昔康联合舒芬太尼用于妇科术后的镇痛效果及不良反应。方法 90例择期妇科手术的患者,随机分为3组,分别以氯诺昔康(A组)、氯诺昔康加舒芬太尼70μg(B组)、舒芬太尼120μg(C组)作为术后静脉自控镇痛(PCA)。以视觉模拟评分法(VAS)和警觉与镇静评分法(OAA/S)来记录术后镇痛期间的疼痛评分和镇静程度,并观察3组的不良反应。结果 B、C组在术后4、8、12h的VAS评分明显低于A组(P<0.01,P<0.05),C组在术后4h的镇静评分中达到3级的病例数要明显高于A组与B组(P<0.05)。3组不良反应发生率无统计学差异(P>0.05)。结论氯诺昔康复合小剂量舒芬太尼作为术后静脉镇痛的效果满意,并且优于单纯使用氯诺昔康,不良反应发生率未增加。

Objective To study the analgesia efficacy and side effects of lornoxicam combined with sufentanil used for gynecological surgery.Methods Ninety patients undergoing elective hysteromyomectomy were randomly divided into three groups：group A received patient-controlled analgesia（PCA） with lornoxicam;group B received PCA with lornoxicam and sufentanil;group C received PCA with sufentanil only.Visual analogue score（VAS） was selectived as the index of pain-intensity;OAA/S sedation scores were done either at the same time points and the adverse effects were observed.Results The VAS of group B and C during the first 12 hours after operation was significantly lower than that of group A（P0.05）,Ramsay sedation scores at 4h during analgesia period of group C were significantly higher than that of group A and group B（P0.05）.The incidence of adverse effects showed no significant difference among the three groups（P0.05）.Conclusion There is a similar incidence of adverse effects among the three groups,but PCA with lornoxicam combined with sufentanil has a better analgesia effect than that with lornoxicam alone.