关键词: 氯诺昔康, 舒芬太尼, 老年患者, 自控皮下镇痛, 髋关节置换术

Abstract: AIM: To evaluate the effect of lornoxicam on efficacy of PCSA with sufentanil after total hip replacement in elderly patients.METHODS: One hundred and twenty five ASA Ⅱ-Ⅲ patients aged 70-90 yrs after total hip replacement performed under general anesthesia were randomly divided into 5 groups(n=25 each)according to the composition of PCSA solution: group S₁L(sufentanil 0.4 μg·kg^-1·d^-1+ lornoxicam 32 mg ),group S₂L(sufentanil 0.6 μg·kg^-1·d^-1+ lornoxicam 32 mg),group S₁(sufentanil 0.4 μg·kg^-1·d^-1), group S₂( sufentanil 0.6 μg·kg^-1·d^-1)and group S₃(sufentanil 0.8 μg·kg^-1·d^-1).In the five groups ,the drugs were diluted 100 mL of normal saline , a loading dose of 2 mL was given at the end of operation.The PCSA setting was as follows: background infusion at 2 mL/h, a bolus dose of 0.5 mL, lockout interval 15 min. The number of deliveries (D₁) and the number of effective deliveries(D₂), total satisfactory degree (TSD), SpO₂, respiratory rate (RR), mean arterial pressure (MAP) and heart rate(HR), Visual analogue scale (VAS) and Ramsay sedation score (RSS) were recorded at 2, 4, 8, 12, 24 and 48 h after after loading dose of sufentanil. The adverse effects during analgesia period such as nausea and respiratory depression, vimiting, pruritis, somnolence were also recorded.RESULTS: The vilal signs was no significant change in four groups. During analgesia period the VAS, D₁, D₂ and TSD was significantly lower in group S₂L than group S₁L,S₁ and group S₂(P<0.05), no significant change as compared with group S₃. RSS was significantly higher group S₂L than group S₁L and group S₂(P<0.05).The percentage of vomiting, nausea, somnolence was significantly lower in group S₂L than group S₃(P<0.05).CONCLUSION: Lornoxicam can improve the efficacy of PCSA with sufentanil in elderly patients after total hip replacement with no significant adverse effect.

Key words: lornoxicam, sufentanil, elderly patients, total hip replacemen, patient cntrolled subcutaneous analgesia