摘要
目的 评价不同剂量氯诺昔康持续静脉输注镇痛 (CVA)用于全髋置换术后患者的有效性和安全性。方法 选择 4 0例择期全髋置换术患者 ,术后随机均分为氯诺昔康 2 0mg组和氯诺昔康 16mg组 ,接受CVA。氯诺昔康 2 0mg组首剂静脉注射负荷量氯诺昔康 2 .3mg(D =1.4 4T1/2 R ;T1/2 为药物半衰期 ,D为负荷剂量 ,R为输注速率 ) ,继之持续静脉输注 2 0mg氯诺昔康。氯诺昔康 16mg组先予负荷量氯诺昔康 1.8mg后 ,继之持续静脉输注 16mg氯诺昔康。 结果 氯诺昔康 16mg组和氯诺昔康 2 0mg组的疼痛缓解评分总和 (TOT PAR)分别为 13.0 1± 4 .6 9和 12 .31± 4 .5 3(P >0 .0 5 ) ,疼痛差值总和 (SPID)分别为 14 .70± 6 .89和 12 .0 0±5 .74 (P >0 .0 5 )。氯诺昔康 16mg组的疼痛程度差值 (PID)于镇痛开始后 1h和 12h时均显著低于氯诺昔康2 0mg组 (P值分别 <0 .0 1和P <0 .0 5 ) ,其疼痛缓解程度 (PAR)评分明显高于氯诺昔康 2 0mg组 (P <0 .0 1)。两组胃肠道不良反应的差异无显著性。结论 全髋置换术后的氯诺昔康首剂负荷剂量静脉注射 ,继之CVA ,镇痛起效快、效果好 ,不良反应轻微。 2 0mg剂量的疼痛缓解程度更好。
Objective To assess the analgesia efficacy and safety of CVA with different doses of lornoxicam in patients undergoing replacement of whole coxa.Methods 40 patients, scheduled for elective replacement of the whole coxa were randomly divided into Lornoxicam 20 mg group ( n =20) and Lornoxicam 16 mg group ( n =20). Lornoxicam 20 mg: the first loading dose of lornoxicam 2.3 mg (D=1.44T 1/2 R) was given intravenously, followed by administration of 20 mg (diluted to 100 ml in 0.9% NaCl) via a CVA pump. Lornoxicam 16 mg group: the first loading dose was 1.8 mg , followed by administration of 16 mg. The rate of CVA pump was 2 ml/h. Results Efficacy was evaluated by comparing: total pain relief (TOTPAR), sum of pain intensity difference (SPID), pain intensity difference (PID) and pain relief (PAR) over 24 hours. Statistically significant difference of Lornoxicam 20 mg and Lornoxicam 16 mg was shown by TOTPAR value 12.31±4.53 and 13.01±4.69, SPID value 12.00±5.74 and 14.70 ±6.89 ,respectively ( P >0.05). But PID value in Lornoxicam 16 mg group was lower than Lornoxicam 20 mg group 1h or 12 h after CVA (1.5±0.8 vs 2.3±0.6 or 1.9±0.1 vs 2.5±0.6), the difference was significant or very significant ( P <0.01 or P <0.05), PAR value was very significantly higher than that in Lornoxicam 20 mg group 12 h after CVA (2.2±0.6 vs 1.4±0.6, P <0.01). Patient's efficacy shown was that Lornoxicam 20 mg to be superior to Lornoxicam 16 mg with a rate of 85% and 70% respectively as good, or excellent.Conclusions This study lornoxicam provides good efficacy for the treatment of pastoperative pain when administered by CVA pump. The onset of the intravenous first loading dose fast of Lornocicam provides an alternative to other drugs for treatment of postoperative pain.
出处
《上海医学》
CAS
CSCD
北大核心
2004年第5期348-351,共4页
Shanghai Medical Journal
