氯诺昔康联合地塞米松超前镇痛用于下肢手术的临床观察

中国临床药理学与治疗学 ›› 2009, Vol. 14 ›› Issue (3): 337-341.

氯诺昔康联合地塞米松超前镇痛用于下肢手术的临床观察

郭伟¹, 金孝岠¹, 郭建荣², 陈小非², 袁晓红²

¹皖南医学院附属弋矶山医院麻醉科, 芜湖241001, 安徽;
²宁波大学医学院附属李惠利医院麻醉科, 宁波315040, 浙江

收稿日期:2008-08-27 修回日期:2008-08-27 发布日期:2020-10-27
作者简介:郭伟, 女, 在读硕士研究生, 研究方向:麻醉与应激。Tel:15156500562 E-mail:gwzdm2004@yahoo.com.cn

Clinical observation of combination lornoxicam and Dexamethasone on preemptive analgesia in lower limbs operation

GUO Wei¹, JIN Xiao-ju¹, GUO Jian-rong², CHEN Xiao-fei², YUAN Xiao-hong²

¹Department of Anesthesiology, Affilited Yijishan Hospital of Wannan Medical College, Wuhu 241000, Anhui, China;
²Department of Anesthesiology, Lihuili Hospital of Medical College of Ningbo University, Ningbo 315040, Zhejiang,China

Received:2008-08-27 Revised:2008-08-27 Published:2020-10-27

摘要/Abstract

摘要： 目的研究氯诺昔康联合地塞米松超前镇痛应用于下肢手术的镇痛效果及安全性。方法将100 例骨科下肢择期手术患者随机分为四组, A组:氯诺昔康(8 mg 溶于2 mL 注射用水) +地塞米松(10 mg, 2 mL) 组;B 组:氯诺昔康(8 mg 溶于2 mL 注射用水) +生理盐水(2 mL) 组;C 组:地塞米松(10 mg, 2 mL) +生理盐水(2 mL) 组;D 组:单纯生理盐水(4 mL) 组。各组于术前30 min 静注相应药物, 术中患者采用连续硬膜外麻醉, 术后予静脉自控镇痛(PCIA, 2 mL h, 48 h)。记录术后2 、4 、8 、12 、24 、48 h 各时点的视觉模拟评分(VAS) 与术后48 h 最痛程度(PD) 评分、术后2 d 平均疼痛程度(MD) 评分来评价其镇痛效果, 以舒适度分级(BCS) 及睡眠障碍度分级(SS) 来评价患者对术后镇痛的满意程度, 记录术后各组辅助镇痛药物的使用情况, 同时观察恶心、呕吐、皮肤瘙痒、嗜睡、切口感染、延迟不愈等相关不良反应。结果 D 组术后2 、4 、8 、12 、24 、48 h VAS 评分高于A 、B 两组(P<0.05), 同时BCS 分级低于A 、B 两组(P<0.05) ;A 组术后2 、4 、8 、12 h 的VAS 评分低于B组(P<0.05) ;术后48 h 内A 组的PD 、MD 、SS 评分均低于其他三组(P<0.05), A 、B 两组辅助镇痛药物的使用量明显少于C 、D 组(P<0.05), 恶心、呕吐的发生率A 组低于其他三组(P<0.05)。结论氯诺昔康联合地塞米松超前镇痛用于骨科手术, 能有效缓解术后疼痛, 提高患者对镇痛的满意程度, 同时减少术后辅助镇痛药物的使用及相关不良反应。

关键词: 氯诺昔康, 非甾体抗炎药, 超前镇痛, 地塞米松, 静脉自控镇痛

Abstract: AIM: To evaluate the effectiveness and safety of combination lornoxicam and Dexamethasone on preemptive analgesia in perioperative of lower limbs. METHODS: 100 patients undergoing lower limbs operation were randomly divided into four groups:group A (n =25) received lornoxicam 8 mg and Dexamethasone 10 mg, group B (n =25) received lornoxicam 8 mg and normal saline, group C (n =25) received dexamethasone 10 mg and normal saline, group D (n = 25) received only normal saline.The corresponding medicines were given at 30 min before anesthesia by intravenous injection, the epidural anesthesia were used during operation, and the. four groups received postoprerative patient-controlled intravenous analgesia (PCIA).The visual analogue scores (VAS) after operation 2, 4, 8, 12, 24 h were recorded and the pointed pain degree (PD), the medium pain degree (MD) after operation 48 h and the Bruggrmann comfort scale (BCS), the somnus scale (SS) were utilized to evaluate analgesia effect and the degree of patients analgesia satisfaction.After operation, the utilization imformations of aid drugs were recorded and the correlated side-effects were observed, such as nausea, disgorging, Itch of skin, drowsiness, infection of incisional wound, delay unrecovery. RESULTS: There were significant differences on group D in the VAS pain scores and Bruggrmann comfort scale at 2, 4, 8, 12, 24, 48 after the operation compared with group A and B (P<0.05). The VAS pain scores in group A decreased at 2, 4, 8, 12 h after the operation (P<0.05) compared with group B, and the PD, MD, SS scores in group A decreased after the operation (P<0.05) compared with the other groups.The consumed aid drugs in group A, B were less than that in group C, D(P<0.05).The incidence rates of nausea, disgorging in group A were lower than that in group B and C and D (P<0.05). CONCLUSIONS: The combination of lornoxicam and Dexamethasone gets more satisfactory analgesia effects and less correlated adverse effects in perioperation of lower limbs.

Key words: lornoxicam, non-steroidal anti-inflammatory drug, preemptive analgesia, Dexamethasone, patient-controlled intravenous analgesia

中图分类号:

R614

郭伟, 金孝岠, 郭建荣, 陈小非, 袁晓红. 氯诺昔康联合地塞米松超前镇痛用于下肢手术的临床观察[J]. 中国临床药理学与治疗学, 2009, 14(3): 337-341.

GUO Wei, JIN Xiao-ju, GUO Jian-rong, CHEN Xiao-fei, YUAN Xiao-hong. Clinical observation of combination lornoxicam and Dexamethasone on preemptive analgesia in lower limbs operation[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(3): 337-341.

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