摘要
目的:观察马来酸氟吡汀联合美洛昔康在前正中开胸二尖瓣置换术患者术后镇痛中的应用效果及安全性。方法:选取我院2017年1月-2018年6月收治的需行前正中开胸二尖瓣置换术的患者200例,采用随机数字表法分为对照组和观察组,各100例。对照组患者于术后第1天开始口服盐酸曲马多缓释片0.1 g,bid+美洛昔康片7.5 mg,qd;观察组患者口服马来酸氟吡汀胶囊0.1 g,tid+美洛昔康片7.5 mg,qd。两组患者的疗程均为1周。若治疗过程中患者出现爆发性疼痛,则以单次肌内注射盐酸曲马多注射液0.1 g进行补救镇痛。观察两组患者术后视觉模拟量表(VAS)评分、镇痛满意度、血清炎症指标含量以及不良反应、补救镇痛的发生情况。结果:研究过程中,两组均无患者脱落。术后48～168 h各时间点,两组患者的VAS评分和血清炎症指标含量均显著低于同组术后24 h,且观察组的VAS评分(术后48～144 h各时间点)和血清炎症指标含量(术后24～168 h各时间点)均显著低于同期对照组(P<0.05)。观察组患者的术后镇痛满意度为85.00%,显著高于对照组的60.00%(P<0.05);观察组患者的不良反应发生率为8.00%,显著低于对照组的20.00%(P<0.05)。两组术后24、48、72 h时和对照组术后96 h时均有患者需要进行补救镇痛,且均只补救了1次,曲马多用量均为0.1 g;两组患者上述时间点的补救镇痛发生率比较,差异均无统计学意义(P>0.05)。结论:与曲马多联合美洛昔康比较,马来酸氟吡汀联合美洛昔康用于前正中开胸二尖瓣置换术患者术后镇痛具有更好的效果,且安全性更高。
OBJECTIVE:To observe clinical efficacy and safety of flupirtine maleate combined with meloxicam for postoperative analgesia in patients undergoing mitral valve replacement via anterior median incision.METHODS:A total of 200 patients received mitral valve replacement via anterior median incision were selected from our hospital during Jan.2017-Jun.2018.They were divided into control group and observation group according to random number table,with 100 cases in each group.Control group was given Tramadol hydrochloride sustained-release tablets 0.1 g orally,bid+Meloxicam tablets 7.5 mg,qd on the first day after surgery.Observation group was given Flupirtine maleate capsules 0.1 g,tid+Meloxicam tablets 7.5 mg,qd,orally.Both groups were treated for one week.If the patient suffered from sudden pain during the treatment,a single intramuscular injection of Tramadol hydrochloride injection 0.1 g was used for remedial analgesia.VAS scores,satisfaction of postoperative analgesia,the contents of serum inflammatory indexes,the occurrence of ADR and remedial analgesia were observed in 2 groups after surgery.RESULTS:During research,no patient withdrew from the study in either group.Forty-eight to one hundred and sixty-eight hours after surgery,VAS scores and the contents of serum inflammatory indexes in 2 groups were significantly lower than 24 h after surgery,VAS scores(48-144 h after surgery)and the contents of serum inflammatory indexes(24-168 h after surgery)in observation group were significantly lower than control group(P<0.05).The satisfaction degree of postoperative analgesia in observation group was 85.00%,which was significantly higher than 60.00%of control group(P<0.05);the incidence of ADR was 8.00%,which was significantly lower than 20.00%of control group(P<0.05).Several patients in both group 24,48 and 72 h after surgery as well as control group 96 h after surgery needed remedial analgesia,and all received remedial analgesia once,tramadol 0.1 g each time.There was no statistical significance in the incidence of rem
作者
林涛
李祥奎
代月娥
刘胜中
LIN Tao;LI Xiangkui;DAI Yue’e;LIU Shengzhong(Dept.of Anesthesiology,Sichuan Academy of Medical Sciences/Sichuan Provincial People’s Hospital,Chengdu 610072,China;Cardiac Surgery Center,Sichuan Academy of Medical Sciences/Sichuan Provincial People’s Hospital,Chengdu 610072,China)
出处
《中国药房》
CAS
北大核心
2018年第22期3142-3145,共4页
China Pharmacy
基金
四川省卫生和计划生育科研课题(No.川卫办发[2016]218号-16PJ460)
关键词
马来酸氟吡汀
美洛昔康
曲马多
术后镇痛
前正中开胸二尖瓣置换术
Flupirtine maleate
Meloxicam
Tramadol
Postoperative analgesia
Mitral valve replacement via anterior median incision
