氯诺昔康静脉注射对鼻内镜术后镇痛效果及血氧饱和度的影响

Effect of intravenous injection of intravenous injection of chlorine on blood oxygen saturation in patients with nasal endoscopic surgery

目的：观察氯诺昔康静脉注射对鼻内镜术后镇痛效果及血氧饱和度的影响。方法：将按美国麻醉医师协会（ASA）分级标准评为Ⅰ-Ⅱ级的择期行鼻内镜手术的120例患者随机分为2组,每组60例。对照组用地佐辛0.8μg/kg加生理盐水至100ml;实验组在此基础上加用氟诺昔康2mg/kg加生理盐水至100ml。分别于术毕清醒时及术后记录生命体征指标,进行疼痛评分（视觉模拟评分法,VAS）及镇静评分（Ramsay评分法）并观察不良反应发生率及调查患者对术后镇痛的满意度。结果：实验组术后4、8、12、24、36、48、72h静息状态的VAS评分及术后24、48、72h活动时的VAS评分均低于对照组,差异有统计学意义（F=1 873.26,P〈0.05）;术后2h、6h,2组pH、PaO2、PaCO2、SpO2比较差异无统计学意义（P〉0.05）。术后24h、48h实验组PaO2、PaCO2、SpO2优于对照组（P〈0.05）;术后6、24、48h实验组患者Ramsay评分优于对照组,差异有统计学意义（F=1 031.35,P〈0.05）;实验组术后患者对疼痛控制教育满意度及对控制或减轻疼痛方法的满意度均优于对照组（χ^2=11.02,P〈0.05;χ^2=9.33,P〈0.05）。结论：氯诺昔康静脉注射应用于鼻内镜术后镇痛中可显著提高镇痛效果,改善患者血气分析情况,提高镇痛效果满意,值得推广应用。

Objective：To observe the effect of intravenous injection of chlorine on postoperative analgesia and blood oxygen saturation in patients with nasal endoscopic surgery. Method： According to the standard of American Society of anesthesiologists（ASA） grading assessment for I - II , undergoing nasal endoscopic surgery of 120 patients were randomly divided into two groups, 60 cases in each group. Control group dezocine 0.8 g/kg＋ physiological saline to 100 ml; on the basis of the experimental group with flurbiprofen 2 mg/kg＋ physiological saline to 100 ml. Respectively in the postoperative recovery and postoperative 2, 4, 12, 24 and 48 h recording vital signs, pain scores（visual analogue score, VAS） and sedation score（Ramsay score） and observe the adverse reaction rate and patient surveys on the satisfaction of postoperative analgesia. Results： The two groups compared test of TKA group after 4, 8, 12, 24, 36 h, 48 h, 72 h resting VAS score and postoperative 24 h, 48 h, 72 h activities of VAS score were lower than the control group, the difference is statistically significant （F= 1 873.26 ,P（0.05）. After 2 h, 6 h, 2 groups of pH, PaO2, PaCO2, SpO2 compared statistically significant（P〉0.05）. After 24h, 48h after test group, PaO2, PaCO2, SpO2 is better than that of the control group（P〈0.05） ; after 6 h, 24 h, 48 h after the test group patients Ramsay Sedation score than the control group, the difference is statistically significant（F= 1 031.35,P〈0.05）. The experimental group after TKA patients of pain control education satisfaction and to control or reduce pain method of satisfaction were superior to the control group, the difference significant（χ^2=11.02, P〈0.05;χ^2 = 9.33, P〈0. 05）. Conclusion： The application of intravenous injection of intravenous injection of chlorine in the postoperative pain of nasal endoscopic surgery can significantly improve the analgesic effect, improve the blood gas analysis, improve the analgesic effect, it is worthy of popularization and application.