《中国康复理论与实践》

《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (07): 613-615.

• 临床研究 • 上一篇    下一篇

氯诺昔康在神经外科麻醉中的应用

阚清; 王保国   

  1. 首都医科大学附属北京天坛医院麻醉科,北京市 100050
  • 收稿日期:2005-10-27 出版日期:2006-07-01 发布日期:2006-07-01

Application of Lornoxicam during Craniotomy

KAN Qing, WANG Bao-guo   

  1. Department of Anesthesiology, Beijing Tiantan Hospital, Capital University of Medical Science, Beijing 100050, China
  • Received:2005-10-27 Published:2006-07-01 Online:2006-07-01

PDF (PC)

摘要： 目的观察术前静脉注射不同剂量氯诺昔康对术中吸入性麻醉药异氟烷呼气末浓度、麻醉恢复及术后镇痛的影响。方法择期神经外科全麻颅脑手术患者60例分为三组对照组(Ⅰ组,n=20)、氯诺昔康8mg组(Ⅱ组,n=20)和氯诺昔康24mg组(Ⅲ组,n=20)。记录术中呼出异氟烷浓度、出血量、输血量、补液量及尿量、术后呼之睁眼、指令运动、定向力恢复的时间。术后48h内定时观察VAS疼痛评分、镇痛药用量。结果各组不同时间点的异氟烷呼气末浓度以Ⅰ组最高,其次是Ⅱ组,浓度最低的是Ⅲ组(P<0.01)。三组患者出血量、输血量、补液量、尿量无显著性差异。患者从停止吸入麻醉,到睁眼、完成指令运动、定向力恢复的时间,Ⅰ组所需时间最长,Ⅱ组居中,Ⅲ组最短(P<0.01)。术后2h、20～24h和44～48h曲马多用量和VAS评分,三组之间无显著性差异。结论术前应用氯诺昔康能够剂量相关性减少术中呼气末异氟烷的浓度,同时维持血流动力学平稳,患者术后清醒快,恢复平稳。

关键词: 非甾体类抗炎药, 氯诺昔康, 开颅手术, 麻醉

Abstract: ObjectiveTo evaluate the effect of lornoxicam used for craniotomy. Methods60 neurosugical patients, ASA physical I～II, were randomly allocated into three groups to receive normal saline in controlled group (GroupⅠ), lornoxicam 8 mg (Group Ⅱ) and lornoxicam 24 mg (Group Ⅲ) intravenously 10～15 min before anesthesia. The end-tidal concentration of isoflurane was measured. The volumes of bleeding, transfusion, fluid infusion and urine were recorded. The time of consciousness, psychomotor and cognitive recoveries from general anesthesia were observed. The VAS scores of pain were evaluated 48 h after operation.ResultsThe concentrations of end-tidal isoflurane in the controlled group were significantly higher than other groups (P<0.01). There was no difference among the three groups in the volume of bleeding, transfusion, infusion and urine. The recovery time of conscious, psychomotor and cognitive from general anesthesia were shorter in group Ⅱ and Ⅲ (P<0.01). The total dose of tramadol and VAS score after the operation were no difference among the three groups.ConclusionThe preoperative application of lornoxicam can reduce the concentrations of end-tidal isoflurane significantly, smooth the recovery from anesthesia.

Key words: nonsteroidal anti-inflammatory drug (NSAID), lornoxicam, craniotomy, anesthesia