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[静脉注射对乙酰氨基酚与氯诺昔康在甲状腺切除术后疼痛中的镇痛效果比较]

[Comparison of the analgesic effects of intravenous paracetamol and lornoxicam in postoperative pain following thyroidectomies].

作者信息

Arslan Mustafa, Ciçek Ramazan, Celep Bahadır, Yılmaz Hüseyin, Ustün Kalender Hülya

机构信息

Department of Anesthesiology and Reanimation, Yüksek İhtisas Hospital, Kırıkkale, Turkey.

出版信息

Agri. 2011 Oct;23(4):160-6. doi: 10.5505/agri.2011.82788.

Abstract

OBJECTIVES

The purpose of the present study was to determine the efficacy of intravenous (iv) paracetamol and iv lornoxicam on postoperative analgesia and the reduction in tramadol consumption.

METHODS

Sixty patients (ASA class 1-2, age: 18-72 years) undergoing thyroidectomy were enrolled in the study, and were randomized into three groups: Group L received 8 mg of iv lornoxicam, Group P received 1 g iv paracetamol and Group C received 100 cc of iv saline solution. All patients received standard general anesthesia. The postoperative salvage analgesic consumption was recorded at 0-6, 6-12 and 12-24 hour (h) intervals. Pain scores were evaluated with a visual analogue scale at 15 min, and 1, 2, 4, 6, 8, 12, 18, and 24 h postoperatively.

RESULTS

The time to first analgesic requirement was approximately 127.5 min in Group L, 162.3 in Group P and 35.5 min in Group C, and the time was found to be significantly prolonged in Group L and Group P. Pain scores were significantly lower in Group P and Group L at 15 min, and 1, 8, 12, and 18 h. Twenty-four hour analgesic consumption was significantly lower in Group P and Group L compared to Group C. Supplemental analgesics requirement was as follows: 100% in Group C, 50% in Group L and 55% in Group P. The degree of satisfaction with postoperative pain management was excellent in 90% in Groups L and P, versus in only 30% in Group C.

CONCLUSION

Administration of iv lornoxicam and iv paracetamol following thyroid surgery decreased the postoperative pain scores and opioid requirement, as well as the incidence of nausea and vomiting, while also prolonging the time to the first analgesic supplement.

摘要

目的

本研究旨在确定静脉注射对乙酰氨基酚和静脉注射氯诺昔康在术后镇痛及减少曲马多用量方面的疗效。

方法

选取60例接受甲状腺切除术的患者(美国麻醉医师协会分级1 - 2级,年龄18 - 72岁)纳入研究,并随机分为三组:L组静脉注射8 mg氯诺昔康,P组静脉注射1 g对乙酰氨基酚,C组静脉注射100 cc生理盐水。所有患者均接受标准全身麻醉。记录术后0 - 6小时、6 - 12小时和12 - 24小时的补救镇痛药物用量。术后15分钟、1小时、2小时、4小时、6小时、8小时、12小时、18小时和24小时采用视觉模拟评分法评估疼痛评分。

结果

L组首次需要镇痛的时间约为127.5分钟,P组为162.3分钟,C组为35.5分钟,发现L组和P组的该时间显著延长。在术后15分钟、1小时、8小时、12小时和18小时,P组和L组的疼痛评分显著更低。与C组相比,P组和L组24小时的镇痛药物用量显著更低。补救镇痛药物的需求情况如下:C组为100%,L组为50%,P组为55%。L组和P组对术后疼痛管理的满意度为90%,而C组仅为30%。

结论

甲状腺手术后静脉注射氯诺昔康和静脉注射对乙酰氨基酚可降低术后疼痛评分、减少阿片类药物需求以及恶心呕吐的发生率,同时还可延长首次补充镇痛药物的时间。

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