酮咯酸氨丁三醇用于日间肛肠手术术后镇痛的效果被引量：3

Effects of ketorolac tromethamine for postoperative analgesia on outpatients undergoing anorectal surgery

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摘要目的观察酮咯酸氨丁三醇用于日间肛肠手术术后镇痛的效果。方法在鞍麻下行日间肛肠手术患者200例，随机分为5组，每组40例。A组术后口服布洛芬300mg／次；B组与c组分别于麻醉前10min静脉给予酮咯酸氨丁三醇30mg与60mg；D组与E组分别于手术后30min静脉给予酮咯酸氨丁三醇30mg与60mg。术后患者若疼痛VAS〉6，给予布洛芬300mg作为补救药物。记录手术结束即刻、术后2、4、6、12、18、72h时VAS评分、术后18、72h时患者满意度评分、药物副作用、并发症以及补救药物的使用情况。结果B、C、D、E组与A组相比，VAS评分在术后4、6、12、18、72h时较低，差异有统计学意义（P〈0．01）；B、C、D、E组手术后VAS评分差异无统计学意义；术后72h时，C、E组较B、D组VAS评分低，差异有统计学意义（P〈0．01）。满意度B、C、D、E组均显著优于A组（P〈0．01）；术后18h时B、C、D、E组满意度差异无统计学意义；术后72h时，C、E组满意度优于B、D组。A组36例患者需要服用布洛芬治疗，显著高于B、C、D、E组；五组之间药物副作用及并发症差异无统计学意义。结论酮咯酸氨丁三醇用于日问肛肠手术术后镇痛安全有效，其中静脉注射酮咯酸氨丁三醇60mg时，镇痛效果更佳。 Objective To evaluate the effects of ketorolac tromethamine on postoperative analgesia in outpatients undergoing anorectal surgery. Methods Two hunderd outpatients scheduled for anorectal surgery under saddle spinal anesthesia were randomly divided into five groups （n=40 each）：group A, B, C, D and E. The patients in group A received oral ibuprofen 300 mg each time after surgery, group B and C ketorolae tro- methamine 30 mg and 60 mg intravenously at 10 rain before the anesthesia respectively, group D and E ketoro- lac tromethamine 30 mg and 60 mg at 30 min after the surgery respectively. The patients were given ibuprofen 300 mg orally for complement when VAS 〉 6. VAS at 0,2,4,6, 12, 18,72 h after the surgery, 4-point verbal rating scale at 18 and 72 h after the surgery were assessed. Side effects, complications, the time and dosage of ibuprofen were noted. Results The VAS in group B, C, D, E were significantly lower than that in group A at 4, 6, 12, 18,72 h after the surgery （P〈 0.01）. VAS in group C and E were much lower than that in group B and D for postoperative analgesia at 72 h after the surgery. The satisfaction rate in group B, C, D, E was significantly higher than that in group A （ P 〈 0.01 ）, without significantly different between group B, C, D, E at 18 h after the surgery. The satisfaction rate in group C and E was higher than that in group B and D at 72 h after the surgery.Thirty-six of forty patients in group A needed ibuprofen, which was significantly higher than that in group B, C, D ,E. There was no significant difference for drug side effects and complications between five groups. Conclusion Intravenous ketorolac tromethamine is a safe and effective method for postoperative analgesia in outpatients undergoing anorectal surgery, in which 60 mg is better.

作者张瑛倪红伟李先华李斌本

机构地区上海市交通大学医学院附属仁济医院嘉定分院、嘉定区中心医院麻醉科上海市长海医院麻醉科

出处《实用疼痛学杂志》 2016年第3期211-214,共4页 Pain Clinic Journal

基金上海市嘉定区卫生局青年科研基金（2013-QN-01）

关键词酮咯酸氨丁三醇日间手术肛肠手术疼痛手术后镇痛 Ketorolac tromethamine Ambulatory surgical procedures Outpatient surgery An- algesia

分类号 R614 [医药卫生—麻醉学]

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