CAJ | 학술논문

目的：观察单次应用地佐辛对腹腔镜下胆囊切除术（LC）患者术后镇痛的效果与不良反应，并和氯诺昔康作比较。方法腹腔镜下胆囊切除术患者60例，随机分为A、B两组，每组30例，两组患者麻醉诱导及维持用药相同。A组术毕前30min给予地佐辛10mg，B组给予氯诺昔康16mg。评估两组患者术后镇痛效果及不良反应。结果术后1h、2h A组VAS评分均明显低于B组（P<0.05）。术后4h、8h两组VAS评分差异无统计学意义。术后8h两组均未发生循环抑制，头痛头晕和尿潴留的发生率低（<3.5%），但A组皮肤瘙痒的发生率均高于B组（P<0.05），而B组恶心呕吐的发生率高于A组（P<0.05）。结论术毕前30min单次静脉注射地佐辛（10mg）、氯诺昔康（16mg），均可使LC患者术后得到满意的镇痛效果，但术后2h内地佐辛较氯诺昔康镇痛作用更强，且恶心、呕吐发生率更低。
목적：관찰단차응용지좌신대복강경하담낭절제술（LC）환자술후진통적효과여불량반응，병화록낙석강작비교。방법복강경하담낭절제술환자60례，수궤분위A、B량조，매조30례，량조환자마취유도급유지용약상동。A조술필전30min급여지좌신10mg，B조급여록낙석강16mg。평고량조환자술후진통효과급불량반응。결과술후1h、2h A조VAS평분균명현저우B조（P<0.05）。술후4h、8h량조VAS평분차이무통계학의의。술후8h량조균미발생순배억제，두통두훈화뇨저류적발생솔저（<3.5%），단A조피부소양적발생솔균고우B조（P<0.05），이B조악심구토적발생솔고우A조（P<0.05）。결론술필전30min단차정맥주사지좌신（10mg）、록낙석강（16mg），균가사LC환자술후득도만의적진통효과，단술후2h내지좌신교록낙석강진통작용경강，차악심、구토발생솔경저。
Objective The purpose of this study was to observe the effects of the postoperative analgesia and adverse reaction of Dezocine and lornoxicam with a single dose intravenous injection in laparoscopic cholecystectomy(LC)patients. Methods Sixty patients following LC were entered in our study. They were randomly divided into 2 groups(group A and B,n=30),all patients with the same agents for anesthesia induction and maintain. 30 min before the end of the procedure 10mg Dezocine was given to patients in group A,and 16mg lornoxicam was given in group B. Then observe the the effects of the postoperative analgesia and adverse reactions of the two drugs at 1h,2h,4h and 8h after the operation separately. Results VAS records in group A were lower than group B significantly at 1h and 2h(both P<0.05)after operation,but with no significant differences between group A and B at 4h and 8h(P>0.05)after operation. Neither of the drugs had adverse effects on circulation,headache and dizziness and uroschesis with lower incidence(<3.5%)in both groups and with no significant differences between the two groups. The pruritus,its incidence in group A was higher than group B(P<0.05),but PONV incidence was lower than group B(P<0.05). Conclusion Our Results show that we could get a satisfy analgesia effect either with Dezocine(10mg)or lornoxicam(16mg)30min before the end of the operation in patients undergoing LC,but in the 2h after operation Dezocine had better analgesia effect than lornoxicam,and with lower PONV incidence.