氯诺昔康用于颅脑手术后镇痛及对白细胞介素-6的影响  

The impact of lornoxican used in anglgesia after brain surgery and IL-6

作　　者：王卓丹[1] 谢广沂[1] 高崇荣[1] 

机构地区：[1]广州医学院第二附属医院麻醉科,510260

出　　处：《中国现代药物应用》2008年第18期14-17,共4页Chinese Journal of Modern Drug Application

摘　　要：目的研究观察氯诺昔康用于颅脑手术后患者自控镇痛(PCA)的效果及对患者血清白细胞介素-6(IL-6)的影响。方法60例ASAⅠ-Ⅱ级择期颅脑手术患者,采用随机、对照的方法将患者分为三组,每组20例。A组用生理盐水作对照组;B组用氯诺昔康PCA;C组用曲马多PCA。术后患者完全清醒后静脉连接PCA泵。术后接泵即刻、术后4、12、24、48h分别记录各时间点的心率、平均动脉压、呼吸频率、血氧饱和度、VAS评分。于诱导前、术后3h、术后24h分别抽取静脉血测定各组患者血清IL-6的含量。结果B组和C组VAS评分均比A组低(P<0.05),两组镇痛效果相近(P>0.05)。三组患者术后血浆IL-6的值均较麻醉前升高(P<0.05),术后3h升高的幅度无明显差异;术后24hC组和B组则有所下降,幅度无明显差异(P>0.05)。结论氯诺昔康用于颅脑术后患者PCA是安全、有效的,能降低术后24h血浆IL-6的水平。Objective To compare the effect of Lornoxicam with tramadol used for patient controlled intravenous analgesia and observe the changes of plasma concentration of Interleukin-6 in patients. Methods 60 adult patients which scheduled for elective craniotomy with general anesthesia were randomly divided into three groups with 20 patients in each group. Group A was given Sodium Chloride as control group ; Group B was given Lornoxicam and group C was given Tramadol. Mean arterial pressure （MAP） , heart rate （HR） , respiratory rate （RR） , pulse oxygen saturation（SpO2） ,VAS were observed in instantly of PCA, 4,12,24,48 h after operation. Concentrations of plasma Interleukin-6 were measured and analyzed before anesthesia,3 h and 24 h after the surgery, Result VAS of group B and group C were lower than group A （ P 〈 0.05 ）. Analgesia in group B and C were similar（ P 〉 0. 05 ）. The levels of plasma Interleukin-6 3 h postoperatively were increased than that at preanesthetic in three groups（ P 〈 0. 05 ）. 24 hours after operation, the concentraction of Interleukin-6 in group A still increased. On the contrary, group B and group C were decreased. There were no difference between group B and group C （ P 〉 0. 05 ）. Conclusion PCA with lornoxicam was safety and effective after craniocerebral operations and it could decrease the level of Interleukin-6 24 h after operation.

关 键 词：氯诺昔康 曲马多 颅脑手术 患者静脉自控镇痛 白细胞介素-6 

分 类 号：R614[医药卫生—麻醉学]