不同镇痛药物对口腔颌面外科术后静脉镇痛的效果与安全性对比分析

Comparative Analysis of Intravenous Postoperative Analgesia Effect between Different Analgesic Drugs on Patients with Oral and M axillofacial Surgery

目的探讨舒芬太尼与氯诺昔康在口腔颌面外科术后静脉镇痛的临床效果和安全性。方法选取2014年4月至2016年8月医院收治的择期口腔颌面外科手术患者76例,随机分为对照组和观察组,各38例。对照组患者予1 mg/kg舒芬太尼+3 mg格拉司琼+100 m L0.9%氯化钠注射液进行术后自控镇痛,观察组患者予32 mg氯诺昔康+3 mg格拉司琼+100 m L 0.9%氯化钠注射液进行术后自控镇痛。分别记录两组患者术后4,8,12,24 h时的镇痛评分,并对比患者的满意度和不良反应发生率。结果术后接受不同镇痛药物治疗后,两组患者不同时段的视觉模拟量表(VAS)评分和镇静量表(RSS)评分差异无统计学意义(P>0.05);对照组镇痛效果满意率为97.37%,与观察组的92.11%差异不显著(P>0.05);观察组患者不良反应发生率为5.26%,明显低于对照组的23.68%(P<0.05)。结论口腔颌面外科术后患者应用氯诺昔康自控镇痛,效果与舒芬太尼相似,但不良反应发生率更低,更利于患者康复。

Objective To investigate the efficacy and safety of sufentanil and lornoxicam on postoperative analgesia effect after oral and maxillofacial surgery.Methods 76 cases of patients who received oral and maxillofacial surgery in the hospital from April 2014 to August 2016 were selected and randomly divided into two groups.The control group received 1 mg/kg sufentanil ＋ 3 mg granisetron ＋0.9%sodium chloride 100 mL for postoperative analgesia;the observation group received 32 mg lornoxicam ＋ 3 mg granisetron ＋ 0.9%sodium chloride 100 mL for postoperative analgesia.The analgesic scores of 4,8,12 and 24 h after surgery in the two groups were recorded and compared,as well as the patients＇ satisfaction and the incidence rate of adverse reactions.Results There was no significant difference in the VAS score and RSS score between the two groupsafter the treatment of different analgesic drugs（P〈0.05）.The analgesic effect of the control group was 97.37%,while the observation group was 92.11%（P〉0.05）.The incidence rate of adverse reaction in the control group was 23.68%,which was obviously higher than 5.26%in the observation group（P〈0.05）.Conclusion Lornoxicam used for analgesia after oral and maxillofacial surgery has similar analgesic effect with sufentanil,but it can significantly reduce the incidence rate of postoperative adverse reactions,which is conducive to the rehabilitation of patients.