氯诺昔康用于学龄儿童术后自控镇痛的临床研究

CLINICAL STUDY OF THE EFFICIENCY AND SAFETY OF PATIENT-CONTROLLED ANALGESIA WITH LORNOXICAM IN SCHOOL CHILDREN

摘要:

目的评价氯诺昔康用于小儿术后自控镇痛的安全性及有效性。方法60例拟行臀筋膜松解术的患儿,随机均分为L组(氯诺昔康组)和T组(曲马多组)。均采用硬膜外加氯胺酮分离麻醉。术毕,L组静注氯诺昔康0.15mg/kg为负荷量,继用0.3mg/kg氯诺昔康加生理盐水稀释至100ml后置于PCA泵药池内。T组静注曲马多1mg/kg为负荷量,继用10mg/kg曲马多加生理盐水稀释至100ml后置于PCA泵药池内。PCA泵背景剂量为5ml/h,PCA量为2ml/次,锁定时间为15分钟。记录使用PCA后1h,4h,8h,12h,20h患儿的疼痛评分、对疼痛治疗总体印象评分及所出现的副作用。结果两组患儿镇痛治疗评分及对镇痛治疗总体印象评分,组间对比均无显著性差异(P>0.05);曲马多组出现恶心,呕吐的病例数目明显高于氯诺昔康组(P<0.01);两组患者PCA治疗前后肝肾功能及出凝血时间比较无统计学意义(P>0.05)。结论氯诺昔康用于小儿术后镇痛是安全有效的,可作为小儿术后镇痛治疗的一种选择药物。

Abstract:

Objective:To assess the analgesic effect and safety of patient controlled analgesia(PCA) with lornoxicam in patient compared with tramadol. Methods: 60 patients undergoing surgical treatments of gluteus muscle contracture with epidural analgesia and ketamine anesthesia were randomly divided into two groups: group L received PCA with lornoxicam and group T received PCA with tramadol. At the end of operation, 0.15mg/kg lornoxicam was injected as starting dose, 0.3mg/kg lornoxicam was diluted to 100ml with normal saline into PCA pump in group L, and 1mg/kg tramadol was injected as starting bolus dose, 10mg/kg tramadol was diluted to 100ml with normal saline into PCA pump in Group T. The subjects received PCA at the following dosages: bolus dose = 2ml; background infusion = 5ml/h. Lockout was for 15 minutes. After PCA had been started, pain scores,global impression score and side effects were assessed at 1h, 4h, 8h, 12h, 20h. Results: There was no difference in pain scores and global impression scores for PCA between the two groups( P >0.05). Lornoxicam caused fewer adverse effects than tramadol( P <0.01). There was no difference in changes of hepatic, renal functions and coagulation before and after PCA( P >0.05).Conclusions: These results indicate that using Lornoxicam via PCA is an effective and safe method to control postoperative pain as well as tramadol in children.