Inanoglu Kerem, Gorur Sadik, Akkurt Cagla Ozbakis, Guven Oguz E, Kararmaz Alper
Department of Anaesthesiology and Reanimation, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.
J Clin Anesth. 2007 Dec;19(8):587-90. doi: 10.1016/j.jclinane.2007.06.012.
To determine whether intravenous injection of lornoxicam 30 minutes before skin incision provides better pain relief after varicocelectomy than postoperative administration of lornoxicam.
Prospective, double-blind, randomized clinical investigation.
Operating room and postoperative recovery area.
44 ASA physical status I and II adult male patients undergoing varicocelectomy.
Patients were randomized either to receive 8 mg lornoxicam infusion 30 minutes before skin incision, followed by saline infusion immediately after skin closure (group 1), or to receive the identical injections but in reverse order (group 2). All patients received local anesthesia with bupivacaine.
Postoperative pain scores were evaluated hourly for the first 8 hours after surgery, then at 12, 16, 20, and 24 hours after surgery, using a 10-cm visual analog scale. Time to first analgesic request and patients' global assessments also were recorded.
Patients in group 1 reported significantly lower pain scores (P < 0.05) at all time intervals except at 24 hours and better global assessment (P = 0.001) than did group 2. There were significantly fewer patients in the preemptive group than group 2 who required rescue analgesic within the first 24 hours (0% vs 22.7%; P = 0.024). Mean time to first analgesic request was also significantly longer in the preemptive group (P = 0.001).
Intravenous lornoxicam administered before surgery has a better analgesic effect for varicocelectomy than when administered postoperatively.
确定在皮肤切口前30分钟静脉注射氯诺昔康与术后给予氯诺昔康相比，在精索静脉曲张切除术后是否能提供更好的疼痛缓解效果。
前瞻性、双盲、随机临床研究。
手术室和术后恢复区。
44例接受精索静脉曲张切除术的ASA身体状况为I级和II级的成年男性患者。
患者被随机分为两组，一组在皮肤切口前30分钟接受8毫克氯诺昔康输注，皮肤缝合后立即接受生理盐水输注（第1组）；另一组接受相同的注射，但顺序相反（第2组）。所有患者均接受布比卡因局部麻醉。
术后疼痛评分在术后前8小时每小时评估一次，然后在术后12、16、20和24小时使用10厘米视觉模拟量表进行评估。记录首次镇痛请求的时间和患者的总体评估。
第1组患者在除24小时外的所有时间间隔的疼痛评分均显著低于第2组（P < 0.05），总体评估更好（P = 0.001）。在24小时内需要急救镇痛的患者中，超前镇痛组明显少于第2组（0%对22.7%；P = 0.024）。超前镇痛组首次镇痛请求的平均时间也显著更长（P = 0.001）。
术前静脉注射氯诺昔康在精索静脉曲张切除术中的镇痛效果优于术后给药。
