Sener M, Yilmazer C, Yilmaz I, Caliskan E, Donmez A, Arslan G
Baskent University, Faculty of Medicine, Department of Otolaryngology, Ankara, Turkey.
Eur J Anaesthesiol. 2008 Mar;25(3):177-82. doi: 10.1017/S0265021507002827. Epub 2007 Oct 22.
We compared the efficacy of intravenous lornoxicam vs. dipyrone in patient-controlled analgesia for postoperative analgesia.
The study included 105 patients who had undergone elective septorhinoplasty after receiving general anaesthesia. Patients were divided into three groups to receive lornoxicam (24 mg day(-1)), dipyrone (5 g day(-1)) or placebo. Pain was evaluated using a 0-100 mm visual analogue scale at 2, 4, 6, 8, 12, 16, 20 and 24 h postoperatively. Pethidine (1 mg kg(-1)) was administered intramuscularly to patients requiring rescue analgesia. Pethidine requirements were recorded during the first 24 h postoperatively, and treatment-related adverse effects were noted.
Postoperative pain scores were significantly lower with lornoxicam compared with dipyrone at 8 h (P = 0.016). No significant differences regarding pain scores at 2, 4, 6, 12, 16, 20 and 24 h were found. Significantly fewer patients in the lornoxicam group required rescue analgesics (vs. dipyrone, P = 0.046; vs. placebo, P = 0.001); fewer patients in the dipyrone group required rescue analgesics compared with placebo (P = 0.008). Significantly fewer patients in the lornoxicam group had nausea (vs. dipyrone, P = 0.022; vs. placebo, P = 0.006); no significant differences were found between the other two groups. Antiemetic use was significantly lower in the lornoxicam group (vs. dipyrone, P = 0.002; vs. placebo, P = 0.001).
Lornoxicam has better tolerability and is a more effective analgesic than dipyrone when administered by patient-controlled analgesia for postoperative analgesia after septorhinoplasty.
我们比较了静脉注射氯诺昔康与安乃近用于患者自控镇痛术后镇痛的疗效。
本研究纳入了105例接受全身麻醉后行择期鼻中隔成形术的患者。患者被分为三组，分别接受氯诺昔康（24毫克/天）、安乃近（5克/天）或安慰剂。术后2、4、6、8、12、16、20和24小时使用0至100毫米视觉模拟量表评估疼痛程度。对需要补救镇痛的患者肌内注射哌替啶（1毫克/千克）。记录术后首24小时内的哌替啶需求量，并记录与治疗相关的不良反应。
术后8小时，氯诺昔康组的疼痛评分显著低于安乃近组（P = 0.016）。在2、4、6、12、16、20和24小时的疼痛评分方面未发现显著差异。氯诺昔康组需要补救镇痛药的患者明显较少（与安乃近组相比，P = 0.046；与安慰剂组相比，P = 0.001）；安乃近组需要补救镇痛药的患者比安慰剂组少（P = 0.008）。氯诺昔康组出现恶心的患者明显较少（与安乃近组相比，P = 0.022；与安慰剂组相比，P = 0.006）；其他两组之间未发现显著差异。氯诺昔康组的止吐药使用明显较少（与安乃近组相比，P = 0.002；与安慰剂组相比，P = 0.001）。
对于鼻中隔成形术后镇痛，通过患者自控镇痛给药时，氯诺昔康比安乃近具有更好的耐受性且镇痛效果更优。
