氯诺昔康超前镇痛在腹腔镜胆囊切除术术后镇痛中的应用

目的研究氯诺昔康超前镇痛对腹腔镜胆囊切除术(L.C)术后镇痛效果的影响。方法择期行L.C的患者50例,随机分成A(氯诺昔康)和B(对照组)两组,A组在切皮前25min予以氯诺昔康8mg静脉注射作为超前镇痛,B组给予等量生理盐水。术后行疼痛评分及不良反应的观察。结果A(氯诺昔康)组术后BCS舒适评分显著高于对照组,两组的不良反应发生率差异无显著性意义。结论氯诺昔康超前镇痛用于L.C术后镇痛效果确切,不良反应少。     

氯诺昔康超前镇痛在腹腔镜胆囊切除术术后镇痛中的应用

目的 研究氯诺昔康超前镇痛对腹腔镜胆囊切除术（L.C)术后镇痛效果的影响。方法 择期行L.C的患50例，随机分成A（氯诺昔康）和B（对照组）两组，A组在切皮前25min予以氯诺昔康8mg静脉注射作为超前镇痛，B组给予等量生理盐水，术后行疼痛评分及不良反应的观察。结果 A（氯诺昔康）组术后BCS舒适评分显高于对照组，两组的不良反应发生率差异无显性意义。结论 氯诺昔康超前镇痛用于L.C术后镇痛效果确切，不良反应少。     

氯诺昔康联合芬太尼用于妇科术后镇痛效果观察

目的观察氯诺昔康联合芬太尼应用于妇科手术后患者自控静脉镇痛的效果和不良反应,探讨这种镇痛方法的可行性。方法妇科手术患者100例,分成两组。氯诺昔康组(50例),术后应用自控静脉镇痛,泵内置氯诺昔康和芬太尼;硬膜外腔吗啡组(50例),术后应用自控硬膜外镇痛,泵内置吗啡和罗哌卡因。用VAS评分标准观察两组患者术后1h、6h、12h、24h、48h时的镇痛效果,记录不良反应的发生率。结果两组患者镇痛的效果大体一致,而吗啡组比氯诺昔康组的不良反应发生率高。结论氯诺昔康与芬太尼联合应用于妇科手术术后的自控静脉镇痛的效果好,不良反应少,值得在临床上应用。     

氯诺昔康全子宫切除术后自控镇痛及其对β内啡肽的影响

目的:评价氯诺昔康用于全子宫切除术后自控镇痛(PCA)的效果和安全性,并观察其对β内啡肽水平的影响。方法:60例全麻下行全子宫切除术术后中度以上疼痛的病人随机分为氯诺昔康组和吗啡组。根据需要启动PCA泵,分别给予氯诺昔康每次0.8mg,吗啡每次1mg,锁定时间5min。以疼痛缓解程度、疼痛缓解总和及24h镇痛总体效果来评价镇痛效果,同时测定血浆β内啡肽、皮质醇浓度。结果:氯诺昔康组与吗啡组的疼痛缓解总和及镇痛总体印象评分无显著差异(P>0.05),吗啡组起效早于氯诺昔康组(P<0.01)。氯诺昔康组的呕吐的发生率明显低于吗啡组(P<0.01)。2组血小板聚集率无显著差异(P>0.05)。启动镇痛泵后3h,2组β内啡肽皆有显著上升,2组间没有显著差异(P>0.05)。结论:氯诺昔康用于全子宫切除术后PCA,效应与吗啡相当,不良反应较少。氯诺昔康可引起β内啡肽的显著升高,其机制有待探讨。     

氯诺昔康静脉联合用药在术后镇痛中的应用及评价

目的:对氯诺昔康静脉联合用药在术后镇痛中的应用进行总结评价,为临床合理使用氯诺昔康提供参考依据。方法:查阅近期国内、外相关文献。结果与结论:非甾体抗炎药氯诺昔康与其他药物联合应用进行术后平衡镇痛,达到镇痛效果并减少了单一药物的不足及不良反应,对疾病转归具有重要的意义。同时,应加强氯诺昔康与其他药物配伍稳定性研究,以保障临床用药安全。     

氯诺昔康用于妇科手术术后镇痛的临床观察

目的 选择手术不同阶段给予氯诺昔康,观察其对术后镇痛疗效和恶心呕吐的影响.方法 选择45例ASAⅠ-Ⅱ级全麻妇科手术病人,均采用静吸复合麻醉,按照氯诺昔康的给药时间分为三组：A组手术结束时静脉注射氯诺昔康0.15mg/kg;B组伤口缝合前30min静脉注射氯诺昔康0.15mg/kg;C组术前静脉注射氯诺昔康0.15mg/kg.三组病人术后接镇痛泵,记录生命体征、镇痛情况及恶心呕吐情况.结果 C组病人的PCA次数明显少于其他两组.镇痛0h,B组恶心呕吐的程度最严重,而镇痛后4h,A组的恶心呕吐程度最严重,到24h,三组相比则无显著差异.结论 C组病人选择术前给药,既可以发挥超前镇痛的作用,又降低了术后恶心呕吐的发生率,因而,术前给予氯诺昔康最为合适.     

氯诺昔康用于腹腔镜卵巢肿瘤切除术后镇痛的临床观察

目的:评价氯诺昔康持续静脉镇痛用于腹腔镜卵巢肿瘤切除术后的临床效果.方法:择期行腹腔镜卵巢切除术的患者60例,随机平均分为氯诺昔康组和对照组两组.氯诺昔康组(n=30)应用PCA镇痛(每次l mL,总量40 mg/48 h),并于手术结束前半小时静脉注射氯诺昔康8 mg.术后行疼痛评分(BCS)及不良反应的观察.对照组(n=30)为空白对照.结果:氯诺昔康组术后BCS评分显著高于对照组.两组的不良反应发生率无显著性差异.结论:腹腔镜卵巢肿瘤切除术后应用氯诺昔康静脉持续镇痛,效果确切,不良反应少.     

氯诺昔康用于术后患者自控镇痛的临床疗效和安全性

目的:评价非甾体抗炎药氯诺昔康用于妇科全子宫切除术后患者自控镇痛(PCA)的疗效及安全性。方法:60例全身麻醉下行全子宫切除术术后出现中度以上疼痛的患者随机分为氯诺昔康组和吗啡组。患者根据需要启动PCA泵(氯诺昔康0.8mg/次,吗啡1mg/次,锁定时间5min)。由疼痛缓解程度(PAR)、疼痛缓解总和(TOT-PAR)和患者24h镇痛总体效果来评价镇痛效果,同时监测血小板聚集率、肝、肾功能,并观察胃肠道反应等。结果:氯诺昔康组和吗啡组的TOTPAR和镇痛总体印象评分无显著性差异(P>0.05)。吗啡组起效早于氯诺昔康 组。氯诺昔康组的恶心呕吐的发生率明显低于吗啡组。2组血小板聚集率无显著性差异(P>0.05)。结论:氯诺昔康用于妇科全子宫切除术后PCA镇痛,其镇痛效应与吗啡相近,不良反应较少。     

氯诺昔康超前镇痛在腹腔镜胆囊切除术中的应用

目的探讨氯诺昔康超前镇痛在腹腔镜胆囊切除术中应用的疗效及安全性。方法选择68例采用腹腔镜胆囊切除术的患者,随机分为氯诺昔康超前镇痛组(氯诺昔康组)和对照组,两组均采用气管插管全身麻醉,氯诺昔康组在麻醉诱导前静脉注射氯诺昔康16mg,对照组在麻醉诱导前静脉注射生理盐水4mL,术后根据患者疼痛情况给予阿片类或鸦片类镇痛药物口服。比较两组患者术后拔管清醒后1h、2h、4h、8h、12h、24h各个时间点的疼痛情况、术后患者满意度与不良反应情况。结果氯诺昔康组患者术后拔管清醒后1h、2h、4h、8h、12h、24h各个时间点的疼痛评分均明显少于对照组(P<0.05)。氯诺昔康组患者术后满意度明显优于对照组(χ=4.22,P<0.05),且术后不良反应发生率明显低于对照组(χ=4.19,P<0.05)。结论氯诺昔康超前镇痛用于腹腔镜胆囊切除术能有效缓解患者术后疼痛,提高患者满意度,减少不良反应的出现,是一种安全有效的镇痛方法。     

氯诺昔康用于开腹手术后患者的自控镇痛

目的:研究氯诺昔康(可塞风)用于开腹手术后患者的自控镇痛临床效果以及对血糖和血皮质醇的影响.方法:45例择期行全麻下开腹手术患者,随机分为氯诺昔康组(L组)、芬太尼组(F组)和氯诺昔康 芬太尼组(C组)行术后镇痛.观察镇痛、镇静效果和测定麻醉前和术后24h时静脉血皮质醇、血糖浓度变化.结果:三组患者术后VAS评分无明显差异(P>0.05);F组术后6h时的镇静评分明显高于L组和C组(P<0.05);三组患者术后24h时的血皮质醇浓度升高无明显差异(P>0.05).结论:氯诺昔康用于开腹手术后患者的自控镇痛临床效果确切,可以作为术后镇痛的较佳选择.     

氯诺昔康凝胶剂的研制

目的制备氯诺昔康凝胶剂,考察其体外经皮渗透性。方法采用紫外分光光度法测定氯诺昔康的表观溶解度和油水分配系数,采用Franz扩散池考察载药凝胶剂的体外经皮渗透性,以6 h累积渗透量为指标,采用正交试验设计筛选最佳处方,探讨了卡波姆浓度、氮酮及丙二醇用量对氯诺昔康凝胶剂经皮渗透的影响,并考察其局部刺激性。结果氯诺昔康在水、pH 6.8和pH 7.4磷酸盐缓冲液中的表观溶解度分别为8.65,86.0和324.0μg/mL,油水分配系数为1.52;正交试验优化的最佳处方为:含0.75%卡波姆、30%丙二醇、4%月桂氮卓酮。制备的凝胶剂外观细腻,黏度适宜,pH值为6.8~7.0,体外经皮渗透实验结果符合零级动力学方程,家兔各涂药部位无水疱、疹块、红肿等现象。结论氯诺昔康凝胶剂制备工艺简单,质量可控。     

紫外分光光度法测定注射用氯诺昔康中氯诺昔康的含量

目的：建立紫外分光光度法,测定注射用氯诺昔康中氯诺昔康的含量。方法：采用紫外分光光度法,检测波长为376nm。结果：氯诺昔康在8.4μg/ml～15.6μg/ml的范围内呈良好的线性关系,r=0.9999,平均回收率为99.76%,RSD为0.13%。结论：本方法可用于注射用氯诺昔康中氯诺昔康的含量测定,简单快捷,结果准确。     

氯诺昔康凝胶剂的制备与临床应用

目的制备氯诺昔康凝胶剂并应用于临床。方法用紫外分光光度法测定含量,并用对照法观察临床疗效。结果含量测定平均回收率为(98.19±1.58)%,RSD=1.19%。应用氯诺昔康凝胶剂治疗类风湿性关节炎患者150例,总有效率93.3%。结论该制剂符合凝胶剂的要求,可试用于临床。     

55例患者应用氯诺昔康镇痛效果及其不良反应回顾性调查

目的 :评价55例住院患者服用氯诺昔康的效果及其不良反应情况。方法 :回顾性调查住院患者应用氯诺昔康的镇痛效果、不良反应发生率及用药合理性。结果 :55例疼痛患者应用氯诺昔康后疼痛缓解率为100 % ;发生药品不良反应3例 (5.45 % ) ;不合理用药18例 (32.73 % ) ;不良反应的发生与患者年龄及不合理合并用药有关。结论 :氯诺昔康镇痛疗效确切 ,但应避免不当的合并用药。     

Preparation and pharmacokinetics evaluation of oral self-emulsifying system for poorly water-soluble drug Lornoxicam

Abstract

The present work was performed aiming to develop a new solid self-emulsifying system (SMEDDS) for poorly water-soluble drug Lornoxicam and evaluate the bioavailability in Wister rats by oral gavage. Liquid SMEDDS of Lornoxicam was formulated with Labrafil M 1944 CS as oil phase, Kolliphor HS 15 as a surfactant and Transcutol HP as a cosurfactant after screening various vehicles. The microemulsion system selected from the phase diagram and optimized by central composite design (CCD) response surface method was transformed into solid-SMEDDS (S-SMEDDS) by lyophilization using sucrose as cryoprotectant. The formulations were further characterized by the particle size, poly dispersity index (PDI), self-emulsifying time, zeta potential, transmission electron microscope (TEM), differential scanning calorimeter (DSC), in vitro drug release and in vivo pharmacokinetics. Results of DSC studies confirmed that the drug was incorporated in the S-SMEDDS. The in vitro drug release from Lornoxicam SMEDDS was found to be greatly higher in comparison with that from the commercial tablets. It was indicated that SMEDDS might be effective in reducing the effect of pH variability of Lornoxicam and improving the release performance of Lornoxicam. HPLC system was applied to study the concentration of Lornoxicam in the plasma of the Wister rats after oral administration of Lornoxicam SMEDDS and Lornoxicam commercial tablets. The pharmacokinetics parameters of the rats were C_max 1065.91?±?224.90 and 1855.22?±?748.25?ngmL^?1, T_max were 2.5?±?0.4?h and 1.8?±?0.5?h, and AUC_0～t were 5316.35?±?323.62 and 7758.07?±?241.57?ngmL^?1?h, respectively. Calculated by AUC_0～∞, the relative bioavailability of Lornoxicam S-SMEDDS was 151.69?±?15.32%. It suggested that this S-SMEDDS could be used as a successful oral solid dosage form to improve the solubility and bioavailability of poorly water-soluble drug Lornoxicam as well.     

The effect of concomitantly administered antacids on the bioavailability of lornoxicam, a novel highly potent NSAID

Antacids are used in the treatment of upper gastrointestinal side-effects during therapy with nonsteroidal anti-inflammatory drugs (NSAIDs). Since pharmacokinetic interactions between antacids and NSAIDs have been reported, it was investigated whether aluminium and magnesium hydroxide (Maalox as oral suspension) or aluminium hydroxide and calcium carbonate (Solugastril as oral gel) influenced the bioavailability of Lornoxicam (rINN), a new potent NSAID from the chemical group of the oxicams. Eighteen male volunteers were given 4 mg of Lornoxicam as a film-coated tablet either alone or together with 10 ml of Maalox or 10 g of Solugastril in an open, randomized, three-way cross-over study. The levels of Lornoxicam in plasma were determined by HPLC following solid-phase extraction. It was found that none of the antacids changed significantly any of the following pharmacokinetic parameters: elimination half-life (t1/2 beta), concentration at peak time (Cmax), time to reach the peak (tmax) and area under the curve to infinity (AUCo-infinity). The results indicate that the concomitant administration of antacids did not influence the pharmacokinetic profile of Lornoxicam. Furthermore they confirm the short elimination half-life of Lornoxicam in man, which is markedly shorter than that of other oxicam-type compounds.     

微创椎间盘术后氯诺昔康PCIA的效果观察与护理对策

目的探讨微创椎问盘手术后氯诺昔康PCIA的镇痛效果与护理对策。方法将120例择期行微创椎间盘髓核摘除术的病人随机分成两组,即L组(氯诺昔康PCIA组)和M组(吗啡硬膜外单次给药组),每组各60例。观察比较两组病人的镇痛效果和不良反应的发生情况。结果两组病人的镇痛效果无显著性差异(P＞O．05),而恶心、呕吐、皮肤瘙痒、尿潴留等不良反应的发生率L组明显低于M组(P＜O．05)。结论氯诺昔康PCIA优于吗啡硬膜外单次给药镇痛,是微创椎间盘手术后较理想的镇痛方法。     

联合麻醉用于药流加无痛人流术的临床观察

目的:观察丙泊酚、氯诺昔康、昂丹司琼联合用于药流加无痛人流术的临床效果.方法:产妇200例,ASAⅠ～Ⅱ级,随机分为2组,每组各100例.观察组为丙泊酚加氯诺昔康与昂丹司琼,联合用药,对照组单用丙泊酚.全程观察产妇血压、心率、呼吸、血氧饱和度、麻醉效果及围术期的不良反应.结果:观察组丙泊酚用量、苏醒时间小于对照组,但无...     

Lornoxicam,a new potent NSAID with an improved tolerability profile

Lornoxicam is a member of the oxicam group of nonsteroidal antiinflammatory drugs (NSAIDs). Oxicams have potent antiinflammatory and analgesic effects, but their use is associated with a high risk of gastrointestinal adverse effects. Lornoxicam has been shown to be at least as effective as comparative NSAIDs and more effective than 10 mg morphine when used at doses > or = 8 mg to control pain after oral surgery. In addition, oral doses of lornoxicam of 16-24 mg daily have been more effective than tramadol 300 mg daily in pain following knee surgery. Lornoxicam combines the high therapeutic potency of oxicams with an improved gastrointestinal toxicity profile as compared to naproxen, for example. This is probably due to the short half-life of lornoxicam as compared to the other oxicams. The clinical trials published so far, mostly comparative, clearly do- cument the efficacy of lornoxicam as a potent analgesic with excellent antiinflammatory properties in a range of painful and/or inflammatory conditions, including postoperative pain and rheumatoid arthritis.