不同剂量氯诺昔康用于神经外科手术后镇痛的比较

Comparison of different doses of lornoxicam for postoperative analgesia in neurosurgical operation

目的比较术前静脉注射不同剂量氯诺昔康对行神经外科手术患者术后镇痛的影响。方法择期神经外科手术患者60例,随机均分为三组,分别在术前10min静注氯诺昔康8mg(L1组)、16mg(L2组)和生理盐水10ml(C组)。记录术后呼之睁眼、指令运动、定向力恢复的时间,以及术后2、24、48h疼痛VAS评分和镇痛药用量。结果三组患者从停止吸入麻醉后至睁眼、完成指令运动、定向力恢复的时间各不相同,C组所需时间最长,L1组居中,L2组最短(P<0.01)。术后2、24、48hL1、L2组PCA总量和按压量均少于C组,且L2组少于L1组(P<0.05),但三组患者VAS评分差异无统计学意义。结论术前应用氯诺昔康能明显减少神经外科手术患者术后镇痛药用量,促进患者术后恢复。

Objective To compare the effects of preoperative administration of different doses of lornoxicam on postoperative analgesia in neurosurgical operation. Methods Sixty patients scheduled for elective neurosurgical operation were randomly divided into three groups to receive preoperative administration of 8 mg lornoxicam （group L1）, 16 rag lornoxicam （group 1.2） or 10 ml normal saline （group C）. The recovery time of eyes opening on calling, moving limbs on command, and self- orientation were recorded. The visual analog scale （VAS） scores of pain and the consumption of narcotics were recorded 2 h, 24 h and 48h after operation. Results The recovery time of eyes opening, following commands and self-orientation was longest in group C, medium in group L1 and shortest in group L2 （P^0.01）. The total amount and the incremental dose of narcotics for patient- controlled analgesia were decreased in group L1 and L2 compared to group C, and were fewer in group L2 than in group L1. Conclusion Preoperative administration of lornoxicam can reduce the consumption of narcotics for postoperative analgesia in patients undergoing neurosurgical operation, and promote the recovery from anesthesia.