芬太尼与氯诺昔康联合用于妇科开腹术后病人PCSA的临床研究

目的 :评价芬太尼与氯诺昔康联合平衡镇痛用于妇科开腹术后病人皮下自控镇痛 (PCSA)的效果。方法 :6 0例在全麻下行开腹妇科手术的患者 ,随机分为芬太尼组 (Ⅰ组 )、芬太尼 +氯诺昔康组 (Ⅱ组 )和氯诺昔康组(Ⅲ组 )各 2 0例行术后镇痛。用双盲法研究。观察用药后 8、12、2 4、4 8h各时间点安静、咳嗽时VAS评分 ,镇静程度 ,病人对疼痛治疗的总体满意度 ,并记录副作用和用药总剂量。结果 :Ⅱ组芬太尼和氯诺昔康的所用剂量分别与Ⅰ组和Ⅲ组比有非常显著性差异 (P <0 .0 1) ,三组安静和咳嗽时VAS评分无显著性差异 (P >0 .0 5 ) ,Ⅱ组消化道副反应发生率 (10 % )比Ⅰ组 (2 5 % )和Ⅲ组 (2 0 % )低 ;Ⅱ组病人满意度 (95 % )比Ⅰ组 (80 % )和Ⅲ组 (85 % )稍高。结论 :芬太尼与氯诺昔康联用平衡镇痛可显著减少每种药的剂量 ,PCSA效果确切 ,副作用较单一用药少 ,可作为术后PCSA的较佳配方选择。

Clinical study of PCSA with fentanyl and lornoxicam combined in patients undergoing abdominal gynecological surgery

Objective To evaluate the effect of subcutaneous patient-controlled analgesia(PSCA) with fentanyl and lornoxicam combined balancedly in patients undergoing abdominal gynecological surgery. Methods Sixty patients undergoing gynecological operation under general anesthesia were randomly divided into three groups (20 each):fentanyl group(Ⅰ)、fentanyl plus lornoxicam group(Ⅱ) and lornoxicam group(Ⅲ),for double-blind study of the effect of postoperative analgesia. The visual analogue score(VAS) when patients were quiet or coughing, degree of sedation,and entire degree of satisfication of patients with pain relief,were observed at 8、12、24 and 48 h after PCSA was initiated.The side effects and total doses of PCSA were recorded. Results Compared with group Ⅰand Ⅲ,the doses of fentanyl and lornoxicam in group Ⅱwere significantly less ( P <0.01).There was no significant difference in VAS(quiet or coughing) among three groups ( P >0.05).The incidence of side effect about alimentary tract in group Ⅱ(10%) was lower than that in group Ⅰ(25%)or Ⅲ(20%).The degree of satisfication of patients in group Ⅱ(95%) was slightly higher than that in group Ⅰ(80%)or Ⅲ(85%). Conclusions PCSA with fentanyl and lornoxicam combined balancedly may significantly reduce the dose of each drug and be characterized by reliable pain relief and less side effects,so it may be one of prior choices of postoperative analgesia.