氯诺昔康和吗啡在自控镇痛中的作用比较

Effect comparison of lornoxicam with morphine in postoperative patient-controlled analgesia

目的 比较氯诺昔康和吗啡在患者静脉自控镇痛中的效果和副作用。方法 选择 6 0例要求使用镇痛泵的患者 ,随机分为氯诺昔康组 (L组 ,n =31)和吗啡组 (M组 ,n =2 9) ,接受静脉自控镇痛治疗 ,L组使用氯诺昔康 (4 8mg/ 4 8h) ,M组使用吗啡 (6 0mg/ 4 8h)。观察 2组患者术后镇痛效果 (疼痛缓解评分总和及疼痛程度差值总和 )、副作用 (瘙痒、恶心和呕吐、尿潴留 )。结果 L组和M组的疼痛缓解评分总和分别为 13 8± 2 8、14 1± 2 6 (P >0 0 5 ) ,疼痛程度差值总和分别为 9 4± 2 1、8 3± 2 9(P >0 0 5 )。L组的瘙痒、恶心和呕吐发生率低于M组 (P <0 0 5 ) ,尿潴留也低于M组 (P <0 0 1)。结论 氯诺昔康在患者静脉自控镇痛的镇痛效果与吗啡相近 ,而其副作用低于吗啡 。

Objective To compare analgesic effects and si de effects of lornoxicam with morphine in postoperative patient-controlled an algesia. Methods Sixty patients who asked postoperative patient -controlled analgesia were randomly divided into two groups: L group( with lor noxicam, n=31,all dose 48 mg/48 h), morphine group (with morphine, n=2 9,all dose 60 mg/48 h). Pain intensity difference (PID) and total pain relief (T OTPAR) were observed in the two groups. At the same time the side effects were i nvestigated in all patients. Results In lornoxicam group an d morphine group TOTPAR was 13 8±2 8, 14 1±2 6 and PID was 9 4±2 1 , 8 3±2 9, respectively. There was no significant difference between two grou ps(P>0 05). The rate of pruritus, nausea and vomit was significantly low er in the lornoxicam group than that in the morphine group (P<0 05). Th e rate of uroschesis was significantly lower in the lornoxicam group than that in the morphine group (P<0 01). Conclusion The antinoc iceptive effects of lornoxicam are similar to morphine in the postoperative pati ent-controlled analgesia. But the side effects of lornoxicam are less than that of morphine. Thus lornoxicam is safe and effective in postoperative patient -controlled analgesia.