|
Objective: To assess lornoxicam used in the clinical efficacy of pediatric postoperative analgesia, and observe its impact on the immune function and blood coagulation to explore the feasibility and safety of lornoxicam for postoperative analgesia in children . Methods: ASA I-II level, 60 cases in children, ages 3 years -7 years old, medium to large elective surgery under general anesthesia were randomly divided into three groups with 20 cases each. A group of ward control group using traditional analgesic; B group lornoxicam 0.03mg/kg/h PCA continuous infusion analgesia; C group received 0.3mg/kg single intravenous infusion of lornoxicam analgesia. In postoperative 4h, 8h, 12h, 24h, 48h five time points observed three groups of children with pain scores (VASf FLACC), Ramsay sedation score (RSS), BCS comfort score, patient global impression score (VRS) and record analgesic during the occurrence of adverse reactions. Each group were collected in the 24 hours prior to surgery and 48 hours after surgery peripheral venous blood testing blood, coagulation, and blood samples from three groups were randomly selected interleukin-8 was measured by enzyme-linked immunosorbent assay (ELISA) 2 (Interlukine 2, IL-2) and interleukin-6 (Interlukine 6, IL-6). Results: The three groups of children's age, weight, gender, operative time was no statistically significant difference (P gt; 0.05) Are basically the same VASf and FLACC pain score results. The postoperative the 12h group B and group C pain score was significantly lower in group A (P lt; 0.05), gradually was no significant difference in pain scores after Group C and Group A (P gt; 0.05). Group B, at each time point pain score decreased, while Group C after 12h pain score higher than 8 hours, consistent and results of BCS comfortable rating. Postoperative three groups of children at each time point Ramsay sedation score (RSS), the incidence of adverse reactions was no significant difference (P GT; 0.05) The children overall impression score (VRS) B group was significantly better than the A, C group (P lt; 0.05). Compared with before surgery, three groups of children after IL-2 were significantly decreased IL-6 was significantly higher (P lt; 0.05), B, C group, the degree of change was significantly less than in group A (P lt; 0.05) . B and C group IL-2 decreased no difference (P GT; 0.05) and IL-6 increased the extent of the B group was significantly smaller than the C group (P lt; 0.05). Preoperative and postoperative three groups of children between the PTS, APTT and the PLT were not significantly different (P gt; 0.05), the only group B and group C PTS than before surgery was significantly longer (P lt; 0.05), but no real clinical significance is still within the normal range. None of the three groups of children with abnormal postoperative bleeding. Conclusion: lornoxicam for pediatric postoperative PCA intravenous continuous analgesia safety, does not significantly increase the incidence of adverse events, no significant effect on platelet count and coagulation; better balance of cytokines and mitigation perioperative of the role of the immune injury, is conducive to the the pediatric postoperative recovery, worthy of clinical application.
|