【摘要】 目的:研究使用氯诺昔康对乳腺癌根治术行超前镇痛的效果及合理用药剂量。方法:选择乳腺癌根治术90例,随机分为A、B、C三组,每组30例。A组于术前30min静注氯诺昔康8mg,B组于术前30min静注氯诺昔康16mg,C组于术前30min静注0.9%NaCl液10mL。均于术后2、4、8、24h各时段对患者进行疼痛数字分级法评分(NRS),并记录术后恶心、呕吐、头晕、嗜睡、瘙瘁、尿潴留等不良反应以及术后镇痛药使用情况。结果:A、B组患者术后2、4、8、24h各时段的NRS显著低于C组(P<0.05),A、B两组比较,B组的NRs在术后2、4、8h三时段显著低于A组(P<0.05),B组的NRs在术后24h虽较A组低,但无统计学意义(P>0.05);A、B两组术后24h内需使用镇痛药的人数明显少于C组(P<0.05),但A、B两组间无统计学意义;三组患者术后不良反应发生率无统计学差异。结论:对乳腺癌根治术患者预先使用氯诺昔康可以达到良好的超前镇痛目的,可减少术后镇痛药的使用,较少不良反应的发生,使用16mg氯诺昔康的镇痛效果较佳。更多还原

【Abstract】 Objective: To investigate the effects of Iornoxicam for preemptive analgesia in patients undergoing radical mastectomy and to determine optimal dosage. Methods: Ninety adult patients (ASA Ⅰ～Ⅱ), scheduled for radical mastectomy surgery, were randomly divided into 3 groups (n=30, each group). Group A consisted of patients who received intravenous infusions of 8mg Iornoxicam 30 minutes before surgery, Group B consisted of patients who received intravenous infusions of 16mg Iornoxicam before surgery, and Group C consisted of patients who were administered 10 ml 9% normal saline intravenously 30 minutes before surgery. Postoperative analgesia efficacy was assessed by a numerical rating scale (NRS) at 2, 4, 8, and 24 hours after surgery, adverse effects (such as nausea, vomiting, dizziness, hypersomnia, pruritus and uroschesis, etc.) and requests for analgesia were recorded. Results: The NRS was significantly lower in group A and B than in group C (P<0.05) at 2, 4, 8, and 24 hours after surgery, and it was significantly lower in group B than in group A (P<0.05) at 2, 4, and 8 hours after surgery. The total number of cases that requested analgesia during 24 hours in group A and B was fewer than in group C (P<0.05). There was no significant difference in adverse effects after surgery among the 3 groups. Conclusion: Preemptive analgesia with Iornoxicam exhibits good analgesic effect in patients undergoing radical mastectomy and reduces the dosage of analgesia and adverse effects. Administration of 16mg Iornoxicam for preemptive analgesia can achieve satisfactory efficacy for postoperative analgesia.更多还原