不同类型镇痛药物在鼻内镜手术术后镇痛效果的研究

目的:针对鼻内镜下鼻中隔矫正术后患者,观察氯诺昔康对应时段静脉应用与阿托品类药物镇痛泵持续使用进行镇痛效果的对比研究。方法:随机选择2016年01月至2016年12月,125例鼻内镜手术患者,76名患者手术包括鼻中隔矫正术,余49例为单纯行鼻窦开放术患者,年龄在16-65岁,根据患者问卷调查可见鼻内镜手术中,含鼻中隔矫正术后和不含该手术方式的患者术后疼痛评分有区别。选择其中50位行鼻内镜下鼻中隔矫正患者,27位患者术后镇痛选择氯诺昔康夜间缓慢静滴,术后阿片类镇痛泵持续使用患者23位,观察,术后疼痛变化情况。结果:术后2小时内两组患者疼痛分级及舒适度分级无明显差别(P>0.05),术后当夜镇痛前两组患者疼痛分级及舒适度分级无差别(P>0.05),术后当夜镇痛后两组患者疼痛分级均降低(P<0.05)及舒适度分级均提高但有差别(P<0.05),术后1-2天两组患者疼痛分级及舒适度分级有差别(P<0.05),术后2-3天两组患者鼻腔硅胶管取出后,均停用镇痛药物疼痛分级及舒适度分级无差别(P>0.05).结论:氯诺昔康为非甾体类镇痛药,具有抑制环氧化酶活性,进而抑制前列腺素合成的作用,还激活内源性阿片神经肽系统,发挥中枢性镇痛作用,具有很强的镇痛作用,对于鼻内镜下鼻中隔矫正术后引起的鼻阻,头痛,鼻痛症状有很好的镇痛效果,且没有阿片类药物的不良反应。

objective:According to the postoperative patients with nasal endoscopic nasal septum correctional,Observed the analgesic effect of and Atropine in analgesic pump and Contrasted.Methods:randomly choosing 125 patients with nasal endoscopic surgery,76 patients with surgery including nasal septum modification between January 2016 and December 2016,more open line 49 cases of isolated sinus surgery patients,aged 16-65 years old,according to the questionnaire,during nasal endoscopic surgery,The pain score of patients with postoperative nasal septum correctional and excluding the operation method of patients with postoperative was difference.Choiced 50 patients with nasal endoscopic nasal septum correction,27 patients with postoperative analgesia choose lornoxicam in vein.23 patients with opioid analgesia pump postoperative,observed,postoperative pain and comfort level.Results:In 2 hours after two groups of patients with pain grading and comfort level classification has no obvious difference(P>0.05),the two groups of patients before night analgesic pain grading and comfort grade difference(P>0.05),postoperative analgesia after that night and two groups of patients with pain grading were lower(P<0.05)and comfort level classification are improving but there are differences(P<0.05),1 to 2 days after two groups of patients with pain grading and comfort grade difference(P<0.05),2-3 days after the two groups of patients with nasal silicone tube removed,all stop using analgesic drugs pain grading and comfort grade difference(P>0.05).Conclusions:lornoxicam was Non-steroidal analgesics,hold up cyclic oxidase activity,hold up the synthesis prostaglandin,act endogeneous opioid peptide,It had a strong central analgesic effect.For nasal endoscopic nasal septum correctional caused by postoperative nasal resistance,headache,nasal symptoms of pain has good analgesic effect,and no adverse reaction of opioid drugs.