美洛昔康对骨科术后的镇痛疗效及其安全性评价

Efficacy and safety evaluation of meloxicam for orthopedic patients with postoperative analgesia

目的探讨美洛昔康对骨科术后的阵痛疗效及其安全性。方法随机选择2011年1月至2012年5月来我院就诊的78例骨科手术患者,所有患者均在术后1 h、24 h肌注15 mg美洛昔康进行镇痛,对镇痛疗效不理想者给予芬太尼注射液进行补充镇痛。评估患者疼痛程度,记录患者术前和术后1周血常规、肝肾功能的变化情况,观察治疗时有无药物相关的不良事件发生。结果患者大手术、中手术、小手术用药前(术后1 h)VAS评分分别为9.2、8.1、7.9,用药后各时间点与基线VAS评分比较有明显下降(P<0.05),使用美洛昔康术后镇痛整体疗效满意;各组疼痛缓解率结果显示,美洛昔康对不同类型手术均有良好的镇痛效果;小型手术患者使用美洛昔康的镇痛效果优于大、中手术患者(P<0.05)。所有患者在术后拔出安置的引流管时,未发生引流量增多等异常现象;治疗期间患者未发生手术切口严重出血、胃痛、胃溃疡、恶心呕吐等与美洛昔康相关的不良反应;未发生心律失常、心肌梗死等不良反应。结论美洛昔康可有效缓解骨科术后疼痛,无明显不良反应,临床用药安全,是有效的骨科术后镇痛药。

Objective To explore the efficacy and safety of meloxicam on orthopedics postoperative analgesi-a. Methods 78 patients with ulcerative colitis in our hospital from January 2011 to May 2012 were chosen,and all the patients were respectively injected with 15 mg meloxicam for analgesia at 1 h and 24 h after operation. Fentanyl analge-sia was added to the patients with incompletely analgesic. The extent of pain was assessed,and the change of blood rou-tine examination,liver and kidney function were recorded before and at 1 week after operation. The drug-related adverse events was observed. Results The VAS scores of patients with major surgery,moderate surgery and minor surgery be-fore treatment （1 h after surgery） were 9. 2,8. 1,7. 9;and the VAS score decreased significantly after medication （P〈0. 05）. The postoperative analgesia effect was satisfactory after using meloxicam. The analgesic effect of meloxicam on different types of operation were good. The analgesic effect of meloxicam in patients with minor surgery was better than those with major surgery and moderate surgery （ P ＆lt;0. 05 ） . No abnormal phenomenon flow increase was observed when drainage tube was drawn out. During treatment,no severe bleeding in surgical incision,stomach pain,stomach ul-cers,nausea,vomit was observed. There was no arrhythmia,myocardial infarction and other adverse events. Conclusion Meloxicam can effectively relieve orthopedic postoperative pain without obvious adverse reaction,it is an effective orthopedic postoperative analgesics with good safety.