静脉注射右酮洛芬、氯诺昔康和双氯芬酸钠对接受曲马多自控镇痛患者术后镇痛效果及曲马多用量的比较研究

A Comparative Study of the Efficacy of IV Dexketoprofen, Lornoxicam, and Diclophenac Sodium on Postoperative Analgesia and Tramadol Consumption in Patients Receiving Patient-Controlled Tramadol.

作者信息

Kılıçkaya Refika, Güleç Ersel, Ünlügenç Hakkı, Gündüz Murat, Işık Geylan

机构信息

Department of Anaesthesiology, Çukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Turk J Anaesthesiol Reanim. 2015 Jun;43(3):174-80. doi: 10.5152/TJAR.2015.15013. Epub 2015 Feb 16.

DOI:10.5152/TJAR.2015.15013

PMID:27366491

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4917186/

Abstract

OBJECTIVE

This study was designed to compare the effects of dexketoprofen, lornoxicam, and diclophenac sodium on postoperative analgesia and tramadol consumption in patients receiving postoperative patient-controlled tramadol after a major abdominal surgery.

METHODS

Eighty patients were randomized to receive one of the four study drugs. Patients in group dexketoprofen (DT) received IV 50 mg dexketoprofen, group lornoxicam (LR) received IV 8 mg lornoxicam, group diclophenac sodium (DS) received 75 mg IV diclophenac sodium and group saline (S) received 0.9% saline in 2 mL syringes, 20 min before the end of anaesthesia. A standardized (1 mg kg(-1)) dose of tramadol was routinely administered to all patients as the loading dose at the end of surgery. Postoperatively, whenever patients requested, they were allowed to use a tramadol patient-controlled analgesia device giving a bolus dose (0.2 mg kg(-1)) of tramadol. Pain, discomfort, and sedation scores, cumulative tramadol consumption, supplemental meperidine requirement, and side effects were recorded.

RESULTS

Visual rating scale and patient discomfort scores were significantly lower in DT, LR and DS groups compared to those in in group S (p<0.001). Cumulative tramadol consumption was significantly lower in non-steroidal anti-inflammatory drug (NSAID)-treated groups at each study period after the second postoperative hour than in group S (p<0.001). Supplemental meperidine requirement was significantly higher in group S at each study period after postoperative 30 min than in NSAID-treated groups (p<0.01).

CONCLUSION

After major abdominal surgery, adding IV diclophenac, lornoxicam or dexketoprofen to patient-controlled tramadol resulted in lower pain scores, smaller tramadol consumption, less rescue supplemental analgesic requirement, and fewer side effects compared with the tramadol alone group.

摘要

目的

本研究旨在比较右酮洛芬、氯诺昔康和双氯芬酸钠对接受腹部大手术后使用曲马多患者自控镇痛的患者术后镇痛效果及曲马多用量的影响。

方法

80例患者随机接受四种研究药物之一。右酮洛芬组（DT）静脉注射50mg右酮洛芬，氯诺昔康组（LR）静脉注射8mg氯诺昔康，双氯芬酸钠组（DS）静脉注射75mg双氯芬酸钠，生理盐水组（S）在麻醉结束前20分钟接受2ml注射器中的0.9%生理盐水。所有患者在手术结束时常规给予标准化剂量（1mg·kg⁻¹）的曲马多作为负荷剂量。术后，患者如有需要，可使用曲马多患者自控镇痛装置，给予负荷剂量（0.2mg·kg⁻¹）的曲马多。记录疼痛、不适和镇静评分、曲马多累计用量、补充哌替啶需求量及副作用。

结果

与S组相比，DT组、LR组和DS组的视觉评分量表和患者不适评分显著更低（p<0.001）。在术后第二小时后的每个研究时间段，非甾体抗炎药（NSAID）治疗组的曲马多累计用量显著低于S组（p<0.001）。术后30分钟后的每个研究时间段，S组的补充哌替啶需求量显著高于NSAID治疗组（p<0.01）。