双氯芬酸钠栓对舌根射频消融术超前镇痛作用的随机双盲对照临床研究  

Efficacy and safety of diclofenac sodium suppository in patients with obstructive sleep apnea hypopnea syndrome undergoing tongue base radiofrequency ablation: randomized double-blinded placebo control trial

作　　者：陈金辉[1] 罗志宏[1] 杨蕊[1] 王永平[1] 杨希林[1] 朱明万[1] 苏玉佩[1] 陶泽璋[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,湖北武汉430060

出　　处：《中国耳鼻咽喉头颈外科》2012年第11期618-620,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：湖北省自然科学基金项目(2009CDB429)

摘　　要：目的评价术前30min使用双氯芬酸钠栓剂1粒(50 mg/粒)对于阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者舌根射频消融术超前镇痛的疗效与安全性。方法采用前瞻性随机双盲安慰剂对照试验设计方法,将38例欲行舌根射频消融术的OSAHS患者随机分为两组,试验组术前30min使用双氯芬酸钠栓剂1粒塞肛,对照组使用不含双氯芬酸钠的安慰栓剂。术后运用视觉模拟量表(visual analogue scale,VAS)评分评估患者术后0、1、2、4、6、8 h疼痛感觉程度,并观察与双氯芬酸钠栓剂有关的不良反应。结果在术后1、2 h试验组术后疼痛VA S评分低于对照组(t分别为-2.6 3 9、-2.3 4 6,P<0.05),差异有统计学意义。术后未见恶心、呕吐等胃肠道不良反应,没有再次或多次使用双氯芬酸钠栓镇痛。结论术前应用双氯芬酸钠栓剂有较好的超前镇痛作用,无不良反应,耐受性良好。OBJECTIVE To evaluate the efficacy and safety of preemptive analgesia with inserting diclofenac sodium suppository 50mg into anus 30 minutes before operation for patients with obstructive sleep apnea hypopnea syndrome （OSAHS） undergoing tongue base radiofrequency ablation （TBRA） . METHODS The trial were randomized, double-blinded, placebo controlled designed. Thirty eight OSAHS patients undergoing TBRA were randomly divided into 2 groups. The patients in test group received preemptive analgesia with inserting diclofenac sodium suppositories 50rag into anus 30 minutes before operation and patients in control group received placebo. Postoperative pain was assessed using Visual Analogue Scale （VAS, 0=no pain 10=worst pain） . The pain was evaluated at 0, 1, 2, 4, 6 and 8 hours after operation. The adverse reaction of diclofenac sodium suppository was also observed. RESULTS VAS score was significantly lower in test group than in control group at lh （t=-2.639, P=0.012） and 2h （t=-2.346, P=0.025） after operation, but there was no significantly difference between the two groups at 0h, 4h, 6h and 8h after operation. Adverse reaction was not observed in the research. No more diclofenac sodium suppository was given to analgesia. CONCLUSION The dosing regimen of diclofenac sodium suppository 50 mg at 30 rain before operation is effective and tolerable for the treatment of TBRA.

关 键 词：睡眠呼吸暂停 阻塞性 电凝术 舌 镇痛 超前 双氯芬酸钠栓 

分 类 号：R614[医药卫生—麻醉学]