氯诺昔康镇痛对烧伤患者术后换药时疼痛和心理的影响

目的观察氯诺昔康在大面积烧伤患者清创植皮术后换药时对疼痛和心理的影响。方法选择大面积烧伤清创植皮术后的患者40例，生命体征平稳，随机分成A、B两组，换药前30min均肌注咪达唑仑0．1mg／kg，B组同时另口服氯诺昔康片8mg，术中用多功能心电监测仪观察两组患者的生命体征，换药完成时评估焦虑、抑郁水平，恐惧程度和镇痛效果并记录疼痛、躁动等不良反应。结果B组换药前10min，换药完成时焦虑、抑郁、恐惧评分及VAS均低于A组（P〈0．05），B组换药期情绪反应（抑郁或兴奋），躁动、疼痛等不良反应也低于A组（P〈0．05），头晕、恶心呕吐不良反应2组无统计学差异（P〉0．05）。结论口服氯诺昔康与肌注咪达唑仑在大面积烧伤患者换药时镇痛、镇静效果良好，不良反应轻微。

Effect of lornoxicam on pain and psychological state of burn patients during dressing change

Objective To investigate the analgesic and psychological effects of lornoxicam on burn patients during dressing change. Methods Forty patients with extensive burn （burn area 45 %） after debridement and skin graft, ASA Ⅰ-Ⅱ , aged 22-58 yrs, were randomly divided into two groups （n=20）. Patients in group A were received an intramuscular injection of midazolam 0. 1mg/kg 30 min before dressing change; Patients in group B received lornoxicam 8 mg orally besides midazolam. MAP,HR and cardiogram were observed. The degrees of anxiety ,depression, fear and pain were valued respectively by Self-rating Anxiety Scale （SAS）, Self-rating Depression Scale（SDS）, Walanable analog scale and VAS. Results At 10 min before and just after dressing change , the scores of SAS, SDS, Walanable level and VAS in group B were lower than that in group A （P〈 0.05）. The incidence of adverse reactions including depression, excitation, restlessness and pain in group B was less than that in group A（P〈0. 05） ,but no difference between the two groups in dizziness, nausea and vomiting. Conclusion Oral lornoxicam and intramuscular midazolam have good analgesic efficacy and psychological influence with mild adverse reactions on burn patients during dressing change.