CAJ | 학술논문

目的观察预注氯诺昔康对腹腔镜阑尾切除术后疼痛的影响.方法 ASA级Ⅰ～Ⅱ行腹腔镜阑尾切除术的患者80例,随机分为实验组和对照组,每组40例.麻醉前实验组静注氯诺昔康16 mg,对照组静注生理盐水4 ml.采用腰硬联合麻醉,术中静注哌替啶、氟哌利多和咪唑安定维持镇静.术后4、8、12、24 h对患者用视觉模拟评分法(VAS)和BCS(Bruggman Comfort Scale)舒适评分法进行评分.记录术后不良反应.结果实验组术后4、8、12、24 h的VAS评分显著低于对照组(1.5±0.6,2.1±0.8,2.0±0.7,1.9±1.0 VS4.9±0.9,5.6±0.8,5.5±0.9,5.4±1.1,P＜0.05);实验组术后4、8、12、24h的BCS评分显著高于对照组(3.9±0.7,3.2±0.8,3.5±0.9,2.8±1.1 VS 1.2±0.8,0.9±0.6,0.9±0.5,0.6±0.8,P＜0.05);使用止痛药的例数也明显少于对照组(4VS 10,P＜0.05).结论预注氯诺昔康用于腹腔镜阑尾切除术患者,可明显减轻术后疼痛,减少止痛药的使用,具有超前镇痛作用.
목적 관찰예주록낙석강대복강경란미절제술후동통적영향.방법 ASA급Ⅰ～Ⅱ행복강경란미절제술적환자80례,수궤분위실험조화대조조,매조40례.마취전실험조정주록낙석강16 mg,대조조정주생리염수4 ml.채용요경연합마취,술중정주고체정、불고리다화미서안정유지진정.술후4、8、12、24 h대환자용시각모의평분법(VAS)화BCS(Bruggman Comfort Scale)서괄평분법진행평분.기록술후불량반응.결과 실험조술후4、8、12、24 h적VAS평분현저저우대조조(1.5±0.6,2.1±0.8,2.0±0.7,1.9±1.0 VS4.9±0.9,5.6±0.8,5.5±0.9,5.4±1.1,P＜0.05);실험조술후4、8、12、24h적BCS평분현저고우대조조(3.9±0.7,3.2±0.8,3.5±0.9,2.8±1.1 VS 1.2±0.8,0.9±0.6,0.9±0.5,0.6±0.8,P＜0.05);사용지통약적례수야명현소우대조조(4VS 10,P＜0.05).결론 예주록낙석강용우복강경란미절제술환자,가명현감경술후동통,감소지통약적사용,구유초전진통작용.
Objective To investigate the effect of pretreatment with lornoxicam on postoperative analgesia in patients undergoing laparoscopic appendectomy. Methods Eighty patients undergoing laparoscopic appendectomy were randomly assigned to receive intravenous lornoxicam of 16 mg (40patients,study group ) or normal saline of 4 ml (40 patients,control group ) before anesthesia. All the patients were anesthetized with combined spinal epidural blockage and tranquilized with pethedine,droperidol and midazolan. Postoperative pain was assessed by visual analogue scale(VAS )and Bruggman Comfort Scale (BCS ). Adverse reactions were noted. Results The VAS scores were lower in the study group than in the control group at hours 2,8,12,and 24(1.5 ± 0.6 vs. 4.9 t 0.9,2.1 ± 0.8 vs. 5.6 ±0.8,2.0 ± 0.7 vs. 5.5 ± 0.9,and 1.9 ± 1.0 vs. 5.4 ± 1.1; P＜0.05 ) and the BCS scores were higher in the study group than in the control group (3.9 ± 0.7 vs. 1.2 ± 0.8,3.2 ± 0.8 vs. 0.9 ± 0.6,3.5±0.9 vs. 0.9 ± 0.5,and 2.8 ± 1.1 vs. 0.6 ± 0.8 P＜0.05 ; while the number of supplemental analgesic use decreased in the study group (4 vs. 10,P＜0.05 ) Conclusions Pretreatment with lornoxicam for patients undergoing laparoscopic appendectomy can relieve postoperative pain while reducing the use of supplemental analgesics.