Chui P T, Gin T
Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Chinese University of Hong Kong.
Eur J Anaesthesiol. 1995 Nov;12(6):597-601.
We compared ketorolac and diclofenac for the prevention and treatment of post-operative pain in patients undergoing laparoscopic sterilization. Fifty ASA I or II women were allocated randomly to receive either diclofenac 75 mg or ketorolac 30 mg intramuscularly 30-90 min before general anaesthesia. Pain scores were assessed half-hourly in the recovery room and then at 2 h and 4 h in the ward. In the recovery room, pain was treated with a second dose of the study drug, followed by parenteral pethidine if necessary. Four patients in the diclofenac group and five patients in the ketorolac group requested no analgesics after surgery. Fifteen patients from each group had satisfactory analgesia after the second dose of study drug. Pain scores were similar between groups at all times. The median (range) initial pain score in the recovery room was 5 (0-9.5) in the diclofenac group and 5 (1-9) in the ketorolac group. Pain at the injection site was more common after diclofenac than ketorolac (12 vs. 3, P < 0.05). In conclusion, both intramuscular diclofenac and ketorolac were relatively ineffective in controlling the pain after laparoscopic sterilization. The drugs were equally well tolerated, but more patients complained of pain at the injection site after diclofenac.
我们比较了酮咯酸和双氯芬酸在接受腹腔镜绝育手术患者中预防和治疗术后疼痛的效果。50名美国麻醉医师协会（ASA）分级为I或II级的女性被随机分配，在全身麻醉前30 - 90分钟肌肉注射75毫克双氯芬酸或30毫克酮咯酸。在恢复室每半小时评估一次疼痛评分，然后在病房2小时和4小时时评估。在恢复室，如果疼痛则给予第二剂研究药物治疗，必要时给予静脉注射哌替啶。双氯芬酸组有4名患者、酮咯酸组有5名患者术后未要求使用镇痛药。每组各有15名患者在第二剂研究药物后获得了满意的镇痛效果。两组在所有时间点的疼痛评分相似。双氯芬酸组在恢复室的初始疼痛评分中位数（范围）为5（0 - 9.5），酮咯酸组为5（1 - 9）。双氯芬酸注射部位疼痛比酮咯酸更常见（12例对3例，P < 0.05）。总之，肌肉注射双氯芬酸和酮咯酸在控制腹腔镜绝育术后疼痛方面相对无效。两种药物的耐受性相当，但双氯芬酸注射部位疼痛的患者更多。
