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相關文獻
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題名 | Comparison of Local Infiltration of Tenoxicam and Intravenous Tenoxicam for Postoperative Analgesia in Herniorrhaphy=局部注射Tenoxicam及靜脈注射Tenoxicam於疝氣手術後止痛效果的比較 |
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作者 | 林志福; 黃家樂; 陳應麟; 王振明; 吳國驊; 魏志清; Lin, Chih-fu; Wong, Kar-lok; Chan, Ying-lun; Wang, Jinn-ming; Wu, Kuo-hwa; Wei, Tze-taur; |
期刊 | 麻醉學雜誌 |
出版日期 | 19980300 |
卷期 | 36:1 1998.03[民87.03] |
頁次 | 頁23-29 |
分類號 | 416.2423、416.2423 |
語文 | eng |
關鍵詞 | 手術後疼痛; 手術,鼠蹊部疝氣修復術; 止痛劑,非固醇類消炎藥:tenoxicam; Pain:postoperative; Surgery:inguinal herniorrhaphy; Analgesics anti-inflammatory agents non-steroids:tenoxicam; |
中文摘要 | 前言:大部分疝氣手術的病人抱怨疼痛發生在術後二十四小時內。tenoxicam 半衰期是 60 至 80 小時,局部注射此藥可以把藥效集中在此範圍,同時劑量較全身性劑量 少,但效果一樣。所以本研究目的是探討術前局部注射 tenoxicam 的效果。 方法:有 60 位病人,ASA 屬於 ClassI 與 ClassII,他們接受單邊疝氣手術,然後隨 機分為四組。麻醉方式是全身麻醉,誘導的藥物是 thiamylal 5mg/kg,fentany12 μ g /kg 及 atracurium0.5mg/kg,第一組 G1 的病人接受 10mg tenoxicam ( 用 10ml normal saline 或 distilled water 調配 ) 術前局部注射於患處,第二組 G2 與第三組 G3 的病 人分別接受 tenoxicam20mg 及 10mg 的術前靜脈注射,第四組的病人是比較組,他們沒有 接受任何方式的注射。每一組的病人都於術後 2 小時、9 小時、24 小時接受疼痛指數評估 。我們記錄了病人服用 acetaminophen (ACT) 或其他止痛藥物的情況。 結果:第一組 G1 的病人在疼痛指數與服用止痛藥物都明顯比其他組少,四組的比較如 下:G1<G2<G3<G4。G2 ,G3 及 G4 疼痛指數與服用止痛藥物並無明顯的差別,第二組 G2 的疼痛指數在術後的晚期( 24 小時的疼痛指數)才比 G4 明顯降低 p<0.05。 結論:在術前局部注射 tenoxicam 於患處可以達到術後止痛 24 小時。 |
英文摘要 | Background: The major complaint of herniorrhaphy is postoperative pain which occurs during the first 24 h after operartion. Tenoxicam has a long half-life of 60-80 h. local infiltration of the drug concentrates the pain control effects in the local area. The local infiltration dose can be smaller than the recommended systemic dose needfully to reach the target area to be effective. Therefore we studied the effect of preoperative local infiltration of tenoxicam on postoperative pain. Methods: Sixty patients, belonging to ASA classes I and II, undergoing unilateral herniorrhaphy, were randomly assigned to 4 groups. General anesthesia was induced with thiamylal 5mg/kg, fentany12 μ g/kg, and atracurium 5mg/kg. Group1 (G1) patients were preoperatively injected with 10mg of tenoxicam on 10 ml normal saline or distilled water, in the operative area. Group 2 (G2) and Group 3 (G3) patients were preoperatively given intravenous tenoxicam, 20mg and 10mg, respectively. Group 4 (G4) patients were no t given preoperative local infiltration or all groups. We recorded the total amount of acetaminophen used and the form of administration of the analgesic drug. All patients received general anesthesia in uniform technique. Results: Pain score and amount of analgesic drug required in G1 (local infiltration group) patients were significantly decreased compared with the other groups. The postoperative pain score of Visual Analog Scale (VAS) and analgesic requirement in the four groups were ranked as follows: G1<G2<G3<G4. No significant difference was observed between G2, G3 and G4. Only the pain score in G2 patients signiflcantly decreased (p<0.05) during the late postoperative period (24 h) when compared with G4 patients. Conclusions: Preoperative local infiltration of tenoxicam can decrease postoperative pain score significantly during the most painful period (24 h) in herniorrhaphy. |
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