摘要
目的 评价氯诺昔康对胃癌患者术后自控静脉镇痛 (PCIA)曲马多用量的影响。方法36例ASAⅠ～Ⅱ级择期胃癌根治术的患者 ,随机分为观察组和对照组。观察组在麻醉前、关腹时分别静注氯诺昔康 8mg ;术后第 1天分两次各静注氯诺昔康 8mg。两组均以佳士比 930 0型电子镇痛泵行曲马多PCIA。镇痛配方为曲马多 1 0mg/kg ,用生理盐水稀释至 1 0 0ml,负荷剂量曲马多 1mg/kg、恩丹西酮 4mg。背景输注 0 5ml/h ,PCA每次 1ml,锁定时间 6min。镇痛期间定时行视觉模拟镇痛评分 (VAS)和舒适度评分 (BCS)。结果 两组具有相同的镇痛效果 ,VAS、BCS均无统计学差异(P >0 0 5 ) ;但观察组 4 8h内曲马多用药量为 (34 2 5± 3 4 1 )ml,明显少于对照组 (4 8 0 8± 3 1 2 )ml(P <0 0 1 )。结论 氯诺昔康明显减少PCIA期曲马多的用药量及其不良反应 。
Objective To assess the influence of lornoxicam on patient controlled intravenous analgesia (PCIA) with tramadol in patients underwent gastric cancer operations.Methods 36 patients (ASAⅠ Ⅱ)scheduled for gastric cancer operations under general anesthesia were randomly allocated to either test group or controlled group with 18 cases each. PCIA with tramadol was given in all patients.The analgesic prescription included tramadol 10 mg/kg diluted with NS to 100 ml.A loading dose of tramadol 1 mg/kg with ondansetron 4 mg was injected,and continous infused at a rate of 0 5 ml/h bolus dose was 1 ml and lock out interval 6 min.Test group was given additional treatment of 8 mg lornoxicam iv at the time of before anesthesia and at the end of operation,and 8 mg twice on the 1st postoperative day. Results Test group had the same analgesic efficacy as controlled group.There was no statistical difference in visual analgesia score (VAS) and Bruggrmann comfort score (BCS) between the two groups at the same time points( P> 0 05). The total dosage of tramadol of test group was (34 25±3 41) ml,which was significantly less than that of the control 〔(48 08±3 12) ml, P< 0 01〕.Conclusion Lornoxicam might significantly decrease the dosage and the side effects of PCIA with tramadol,and be a good selective drug for multiple modal analgesia.
出处
《临床麻醉学杂志》
CAS
CSCD
2003年第10期604-606,共3页
Journal of Clinical Anesthesiology
基金
江苏省医学重点人才资助项目 (RC2 0 0 2 48)
