氯诺昔康和舒芬太尼用于颌面外科术后自控静脉镇痛的比较  

Comparison of antalgic effects of patient-controlled intravenous lornoxicam and sufentanil in patients after oral maxillofacial surgery

作　　者：董稳[1] 刘瑞昌[1] 刘克英[1] 关明[1] 杨旭东[1] 

机构地区：[1]北京大学口腔医学院.口腔医院麻醉科,北京100081

出　　处：《北京大学学报（医学版）》2009年第1期109-111,共3页Journal of Peking University:Health Sciences

摘　　要：目的：比较氯诺昔康（lornoxicam）和舒芬太尼（sufentanil）用于颌面外科术后自控静脉镇痛（patient—controlled intravenous analgesia，PCIA）的作用和不良反应。方法：200例美国麻醉医师协会（American Society of Anesthesiologists，ASA）Ⅰ～Ⅱ级择期口腔颌面外科手术全麻患者，分为氯诺昔康组（L组）和舒芬太尼组（S组），每组100例，分别接受氯诺昔康和舒芬太尼作为术后镇痛药物。记录开始镇痛后4，8，12，24，48h两组的疼痛视觉模拟评分（visual analogue scale，VAS）、Prince—Henry疼痛评分（Prince—Henry score，PHS）、Ramsay镇静评分（Ramsay sedation score，RSS）和治疗期间可能出现的不良反应，镇痛结束后统计患者对镇痛治疗的总体满意度。结果：两组术后镇痛治疗期间各时间点疼痛VAS、PHS及RSS组间比较差异无统计学意义。两组镇痛结束后对镇痛治疗的总体满意度差异无统计学意义。镇痛治疗期间L组恶心、呕吐和头晕的发生率低于S组（1％ vs 9％，0 vs 4％，0 vs 3％，P〈0．05）；两组其他不良反应的比较差异无统计学意义。结论：氯诺昔康和舒芬太尼用于颌面外科术后镇痛，均能取得满意的镇痛效果，氯诺昔康不良反应发生率较低。Objective：To compare the analgesic efficiency and adverse effects of postoperative patientcontrolled intravenous an algesia （PCIA） with lornoxicam and sufentanil in patients undergoing oral maxillofacial surgery. Methods： 200 ASA（American Society of Anesthesiologists）Ⅰ - Ⅱ patients who undertook oral maxillofacial operation were divided into two groups： lornoxicam group （group L） and sufentanil group （group S） ,with 100 patients in each group. The effectiveness was assessed with visual analogu scale （VAS）, Prince-Henry score（PHS） and Ramsay sedation Score（RSS） at different time points： 4, 8, 12, 24 and 48 h after the beginning of analgesia. The analgesic efficacy of analgesia and the adverse effects during analgesia period were observed. Results： Statistical analysis revealed no significant difference in VAS, PHS and RSS at 4, 8, 12, 24, 48 h and the overall satisfaction on analgesia therapy. The percentage of nausea, vomiting and dizziness was significantly lower in group L than that in group S （ 1% vs 9% ,0 vs 4% ,0 vs 3%, P 〈0. 05）. Conclusion： Lornoxicam could provide an identical efficacy as sufentanil in the postoperative PCIA in patients undergoing oral maxillofacial surgery. In addition, lornoxieam caused less adversed effects.

关 键 词：氯诺昔康 舒芬太尼 镇痛 口腔外科手术 

分 类 号：R782.054[医药卫生—口腔医学]