氯诺昔康和曲马多用于颌面部术后病人静脉自控镇痛的比较  

Comparison of postoperative patient-controlled intravenous analgesia effects between lornoxicam and tramadol on patients undergoing of oral maxillofacial surgery

作　　者：罗玉琳[1] 郁葱[1] 

机构地区：[1]重庆医科大学附属口腔医院麻醉科,重庆400015

出　　处：《重庆医科大学学报》2006年第2期266-267,274,共3页Journal of Chongqing Medical University

基　　金：重庆市卫生局资助项目(04-2-003)

摘　　要：目的:比较氯诺昔康和曲马多对颌面部手术病人术后镇痛作用及不良反应。方法:40例颌面部手术病人随机分为两组,Ⅰ组(n=20)氯诺昔康组,Ⅱ组(n=20)曲马多组,均采用澳美电子镇痛泵PCA,其内设置和控制的参数有:(1)持续剂量:2ml/h;(2)锁定时间:20min;(3)PCA剂量:1ml。分别于术后12h、24h、36h、48h随访观察镇痛效果(VAS法)、镇静程度(Ramsay评分)、按压次数以及呼吸抑制、恶心呕吐、头昏等副作用。结果:两组病人VAS评分分别为2.1±1.6和2.5±1.7(P>0.05),镇痛效果差异无显著性意义。氯诺昔康组术后恶心例数为2例,曲马多为8例(P<0.01);呕吐例数分别为1例和4例。结论:氯诺昔康和曲马多均可于颌面部病人术后镇痛,而氯诺昔康镇痛效果更好,不良反应轻,是颌面部手术患者较为理想的术后镇痛模式。Objective： To compare the analgesic efficiency and adverse drug reactions of patient-controlled intravenous analgesia （PCIA） with Lornoxicam and Tramadol in patients undergoing the operation in cranio-cervical region. Methods： Forty ASA Ⅰ - Ⅱ adult patients, who undergoing the operation in cranio-cervical region were randomly divided into two groups, both of which were diluted into 100ml with sodium and background 2ml/h, lockout time 15min, PCA bolus 0.5ml. The efficiency of analgesia provided by PCA was assessed by： （1）visual analogue scale （VAS） at 12, 24, 36h, 48h after the operation; （2）adverse drug reactions such as nausea and vomiting, dizziness, respiratory depression and so on. Resets： There was no statistically significant difference between the two groups in VAS score （P 〉 0.05）, There were 2 cases of nausea and one case of vomit in Lornoxicam group,as compared with 8 cases of nausea and 4 cases of vomit in Tramadol group. The number of nausea is 2 vs 8 （P〈0.01）, voimiting 1 vs 4 in the two groups. Conclusion： Both lornoxicam and tramadol can be used in postoperative analgesia for patients undergoing oral maxillofacial surgery, of which lornoxicam has a better analgesia effect with less side effect and is a preferable choice. When used in patient-controlled intravenous analgesia, Lornoxicam has a safe and effect, condition, It can decrease the occurrence of side-effect each other when used with tramadol, especially nausea and vomit.

关 键 词：氯诺昔康 曲马多 自控镇痛 

分 类 号：R782.054[医药卫生—口腔医学]