氯诺昔康,吗啡和曲马多用于妇科开腹手术后患者自控镇痛的比较

Patient-controlled Analgesia with Lornoxicam in Patients Undergoing Gynecol ogical Surgery

目的评价非甾体抗炎药氯诺昔康用于妇科开腹手术后患者自控镇痛patient-controlledanalgesiaPCA的安全性及有效性。方法选择89例择期妇科开腹手术患者,术后随机分为L组n=30,M组n=30和T组n=29,接受PCA治疗。L组使用氯诺昔康(1mg/次,总量32mg/24h),M组使用吗啡(1.25mg/次,总量40mg/24h),T组使用曲马多(12.5mg/次,总量400mg/24h)。结果氯诺昔康组与吗啡及曲马多组的疼痛缓解评分总和(TOTPAR)分别为15.2±3.916.4±3.5和15.9±4.4(P>0.05),疼痛程度差值总和(SPID)分别为10.3±3.19.0±2.0和9.2±4.7(P>0.05)。氯诺昔康组的胃肠道副作用低于吗啡和曲马多组,三组分别为3例10.0%,8例26.7%和5例(17.2%)。结论氯诺昔康用于妇科开腹手术后PCA的效应与吗啡和曲马多接近,可引起轻度的胃肠道症状。

Objective To assess the analgesic effect and side effects of PCA with lornox icam compared with morphine and tramadol.Methods 89patients,scheduled for el ective hysterectomy or hysterom yomec t-omy,were randomly divided into Group L ,Group M and Group T.Three drugs administered iv via a patient -controlled ana lgesia for up to24h postoperatively.Results Efficacy was assessed by comparin g total pain relief(TOTPAR)and sum of pain intensity difference(SPID)over2 4h.Statistically signi -ficant equivalence of lornoxicam,morphine and tramad ol was shown by TOTPAR values15.2±3.9,16.4±3.5and15.9±4. 4,by SPID values10.3±3.1,9.0±2.0and9.2±4.7,respectivel y(P>0.05).Lornoxicam caused fewer adverse events than morphine and trama dol(10.0%,26.7%and17.2%of patients,respectively).Conclusion The study suggests that lornoxicam provides an alternative to mor-phine or trama daol for the treatment of postoperative pain.