舒芬太尼联合氯诺昔康对术后静脉自控镇痛的效果观察

Clinical assessment of sufentanil in PCIA combining with lornoxicam

目的观察舒芬太尼与氯诺昔康联合用药在术后静脉自控镇痛治疗中的效果及不良反应。方法随机选取120例ASA分级为Ⅰ~Ⅱ级,在全身麻醉下进行择期根治性胃癌切除手术的患者,随机均分为舒芬太尼组（S组）、氯诺昔康联合舒芬太尼组（M组）;S组以舒芬太尼＋托烷司琼做术后静脉自控镇痛,M组以氯诺昔康联合舒芬太尼＋托烷司琼做术后静脉自控镇痛。记录开始术后镇痛后4,8,12,24和48h2组的疼痛视觉模拟评分（VAS）、Prince-Henry疼痛评分（PHS）、Ramsay镇静评分（RSS）和治疗期间出现的不良反应,以及患者对镇痛治疗的总体满意度。结果 2组在术后镇痛治疗期间各时间点VAS、PHS及RSS的比较差异无统计学意义。S组与M组2组患者对镇痛治疗的总体满意度无明显差别。但镇痛治疗期间M组恶心、呕吐的发生率低于S组（6%vs 1.6%,8%vs 2%,P〈0.05）;不良反应的组间比较无统计学差异。结论氯诺昔康联合舒芬太尼用于普通外科术后静脉自控镇痛可以取得满意的镇痛效果。

Objective To observe the curative and adverse effect of the combination of sulfentanil and lornoxincam in the postoperation analgesia.Methods 120ASA（American Society of Anesthesiologists,ASA）bandⅠ-Ⅱ patients who accepted surgical intervetion under general anasthesia were divided randomly into the sulfentanyl group（S group,60patients）and the combination of sulfentanyl and lornoxincam group（M group,60patients）.S group was treated with sulfentanyl and tropisetron,M group with sulfentanyl,lornoxincam and tropisetron.The VAS（Visual analogue score）,PHS（Prince-Henry score）、RSS（Ramsay sedation score）,the possible adverse reaction during the process and the overall satisfactory degree after analgesia were recorded.Results The VAS、PHS and RSS showed no significant difference at different time piont and in different subgroup in M group.The overall satisfactory degree between S group and M group showed no significant difference after analgesia P〉0.05.But the wickedness and vomtive incidence in M group were significant lower than in S group（6% vs 1.6%,8% vs 2%,P〈0.05）.The other adverse effect showed no statistical difference.Conclusion The combination of lornoxincam and sulfentanyl can achieve satisfactory analgesia effect post surgical operation,and the side effect was lower than sulfentanyl alone.