O'Hanlon J J, Beers H, Huss B K, Milligan K R
Department of Anaesthesia, Lagan Valley Hospital, Lisburn, Northern Ireland.
Eur J Anaesthesiol. 1996 Jul;13(4):404-7. doi: 10.1046/j.1365-2346.1996.d01-365.x.
Sixty patients presenting for in-patient gynaecological laparoscopic surgery were randomly allocated to receive either diclofenac 75 mg (n = 20), ketorolac 30 mg (n = 20) or piroxicam 20 mg (n = 20) as an intramuscular (i.m.) injection immediately after induction of anaesthesia. Post-operative Visual Analogue Scores at rest, over the first 24 h after surgery, using a 10 cm scale, ranged from 3.2-0.5 in the diclofenac group, 2.7-0.85 in the ketorolac group and 2.8-0.5 in the piroxicam group. The scores did not differ significantly between the three groups (P > 0.05). Mean time (SD) to first analgesia was 27 (94) min in the piroxicam group, 16 (30) min in the diclofenac group and 62 (120) min in the piroxicam group. Six out of 20 patients in the diclofenac group required further analgesia compared with nine out of 20 in the other two drug groups, this was not significant. There were no reports of increased bleeding, bronchoconstriction, bleeding from the upper gastrointestinal tract, renal impairment or pain from the intramuscular (i.m.) injection site in any of the groups. The administration of a non-steroidal anti-inflammatory drug to patients presenting for laparoscopic surgery reduces post-operative pain and analgesic requirements, and piroxicam 20 mg provides a suitable alternative to 75 mg diclofenac and 20 mg ketorolac.
60名接受住院妇科腹腔镜手术的患者被随机分配，在麻醉诱导后立即接受肌肉注射双氯芬酸75毫克（n = 20）、酮咯酸30毫克（n = 20）或吡罗昔康20毫克（n = 20）。术后使用10厘米量表测量的静息视觉模拟评分在术后头24小时内，双氯芬酸组为3.2 - 0.5，酮咯酸组为2.7 - 0.85，吡罗昔康组为2.8 - 0.5。三组之间的评分无显著差异（P > 0.05）。首次镇痛的平均时间（标准差）在吡罗昔康组为27（94）分钟，双氯芬酸组为16（30）分钟，酮咯酸组为62（120）分钟。双氯芬酸组20名患者中有6名需要进一步镇痛，而其他两组20名患者中有9名需要进一步镇痛，差异无统计学意义。所有组均未报告有出血增加、支气管收缩、上消化道出血、肾功能损害或肌肉注射部位疼痛的情况。对接受腹腔镜手术的患者使用非甾体抗炎药可减轻术后疼痛和镇痛需求，20毫克吡罗昔康是75毫克双氯芬酸和30毫克酮咯酸的合适替代药物。
