鼻内镜术后不同镇痛方式效果的研究

目的:针对鼻内镜手术术后患者,观察罗哌卡因局部鼻腔给药和罗诺昔康对应时段静脉应用的镇痛效果对比及适用对象选择的研究。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。其中53位行鼻内镜下鼻中隔矫正患者和49名单纯鼻内镜下鼻窦开放术患者,术后镇痛选择鼻腔点滴1%罗哌卡因,镇痛无效患者可选择氯诺昔康夜间缓慢静滴患者47位,观察,术后疼痛变化情况。结果:鼻内镜下鼻中隔矫正术后及单纯鼻窦开放术后均需要镇痛治疗,鼻中隔矫正术后患者疼痛更加明显;故予以1%罗哌卡因局部滴用镇痛,鼻中隔矫正患者无效者40人(40/53),单纯鼻窦开放术患者无效者5位(5/49);根据患者意愿,予以进一步镇痛,慢滴氯诺昔康,镇痛效果良好(t=18.19,p≤0.05)结论:对于不同方式的鼻内镜手术,术后疼痛程度不同,含鼻中隔矫正术的患者,术后需要夜间应用氯诺昔康持续静滴缓解疼痛,但对于单纯鼻内镜下比窦开放术的患者,术后可应用罗哌卡因局部鼻腔点滴的方法即可起到较好的镇痛作用。

objective:For patients with nasal endoscopic surgery,observing the Analgesic effect contrast of the ropivacaine hydrochloride by local nasal drug delivery and Lornoxicam for Injection and the selection of Applicable object selection.Methods:Randomly choosing between January 2016 and December 2016,125 patients with nasal endoscopic surgery,76 patients with surgery including nasal septum modification,49 patients with isolated sinus surgery,aged 16-65 years old,According to the questionnaire visible nasal endoscopic surgery,patients with postoperative nasal septum correctional and excluding the operation method of patients with postoperative pain score difference.53 patients with nasal endoscopic nasal septum correctional and 49 patients with pure nasal endoscopic sinus operation,choosing the1%ropivacaine hydrochloride by local nasal drug delivery postoperation,But 47 patients with Invalidanalgesic patient,Choosing chloroxicam at night and slow down and observe.Results:The postoperative treatment of nasal septal correction and the opening of sinus surgery were all required to be treated with analgesic therapy,and the pain was more obvious after septal correction.Therefore,1%ropivacaine was used to relieve the pain,and the patient with septal correction was 40(40/53),and the patients with the open nasal sinus open surgery were 5(5/49).According to the patient’s will,the pain was further analgesic,and the analgesic effect was good(P<0.05).Conclusion:For different ways of nasal endoscopic surgery,postoperative pain degree,including patients with nasal septum modification,Postoperative patients with nasal septum modification,application of chlorine need night yesterday,continuous static drops of pain relief,but for pure than endoscopic sinus operation patients with postoperative applicable luo pp because local nasal drip method can better analgesic effect.