Department of Anesthesiology, Faculty of Medicine, King Faisal University, Dammam 31413, Saudi Arabia.
J Clin Anesth. 2011 Mar;23(2):97-101. doi: 10.1016/j.jclinane.2010.07.002.
To evaluate the efficacy of preoperative lornoxicam on postoperative pain management following tonsillectomy.
Prospective, randomized, double-blinded, placebo-controlled study.
King Fahd University Hospital.
40 adult, ASA physical status I and II patients scheduled for tonsillectomy.
Patients were randomly allocated to two groups to receive either intravenous (IV) lornoxicam 16 mg (Group L) or saline as control (Group C) preoperatively. Anesthesia was induced using IV fentanyl and propofol, while endotracheal intubation was facilitated with rocuronium, and maintenance was accomplished using nitrous oxide and sevoflurane.
Pain scores at rest and on swallowing, intraoperative bleeding, interval until first request for rescue diclofenac suppository, and total diclofenac dose given in the first 12 and 24 hours postoperatively were recorded. The frequency of postoperative complications including bleeding, hypoxia, nausea and vomiting also were observed.
Pain scores at rest were significantly lower in Group L than Group C at all observation times. Similarly, pain scores on swallowing were lower in Group L during the first 4 postoperative hours. The maximum verbal pain scale (VPS) in the control group was 7 (5.75 - 8 median, interquartile range) and in the lornoxicam group, it was 4 (4 - 5 median, interquartile range) (P < 0.001). The total diclofenac dose during the immediate postoperative 12 hours was significantly lower in Group L than Group C (65 ± 24 mg vs. 20 ± 25 mg, respectively; P < 0.001). No significant differences were noted for intraoperative bleeding. The frequency of postoperative nausea and vomiting was similar in both groups.
Preoperative 16 mg lornoxicam was effective for immediate postoperative pain relief after tonsillectomy in adults.
评估术前使用氯诺昔康在扁桃体切除术后疼痛管理中的疗效。
前瞻性、随机、双盲、安慰剂对照研究。
法赫德国王大学医院。
40 名成年、ASA 身体状况 I 和 II 级患者，计划行扁桃体切除术。
患者随机分为两组，分别接受静脉注射（IV）氯诺昔康 16mg（L 组）或生理盐水作为对照（C 组）。麻醉诱导采用 IV 芬太尼和丙泊酚，气管插管采用罗库溴铵辅助，维持采用氧化亚氮和七氟醚。
记录静息和吞咽时的疼痛评分、术中出血、首次要求使用双氯芬酸钠栓剂的间隔时间、以及术后 12 小时和 24 小时内给予的总双氯芬酸钠剂量。还观察了术后并发症（包括出血、缺氧、恶心和呕吐）的发生频率。
L 组在所有观察时间的静息时疼痛评分均显著低于 C 组。同样，L 组在术后 4 小时内吞咽时的疼痛评分也较低。对照组的最大口述疼痛评分（VPS）为 7（5.75-8 中位数，四分位距），氯诺昔康组为 4（4-5 中位数，四分位距）（P<0.001）。L 组在术后 12 小时内的总双氯芬酸钠剂量明显低于 C 组（分别为 65±24mg 和 20±25mg；P<0.001）。术中出血无显著差异。两组术后恶心和呕吐的发生率相似。
术前使用 16mg 氯诺昔康可有效缓解成人扁桃体切除术后的即刻疼痛。
