Effects of lornoxicam combining with fentanyl on postoperative arrhythmia and platelet function in patients with coronary artery disease after abdominal surgery
- VernacularTitle:氯诺昔康混合芬太尼对冠心病病人腹部手术后心律失常和血小板功能的影响
- Author:
Jun WANG
;
Yiping HU
;
Haozhong DING
- Publication Type:Journal Article
- Keywords:
Anti-inflammatory agents;
Fentanyl;
Coronary arteriosclerosis;
Arrhythmia;
Platelet function tests
- From:
Chinese Journal of Anesthesiology
1994;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effects of patient-controlled intravenous analgesia (PCIA) with lornoxicam and fentanyl on arrhythmia and the expression of platelet membrane glycoproteins in patients with coronary artery disease (CAD) after abdominal surgery.Methods Eighty ASA II or III patients with CAD aged 51-66 yrs weighing 59-68 kg presenting for bdominal surgery participated in this study. CAD was diagnosed by clinical symptoms and ischemic changes on ECG. The patients were premedicated with intramuscular henobarbital 0.1 g and scopolamine 0.3 mg. Anesthesia was induced with fentanyl, droperidol, propofol and vecuronium and maintained with propofol, fentanyl and vecuronium. The patients received PCIA after operation. The PCIA solution contained fentanyl 0.9 mg and droperidol 5 mg in 100 ml of normal saline (N.S. ) in group A ( n - 40) or lomoxicam 56 mg, fentanyl 0.2 mg and dropendol 5 mg in 100 ml N.S. in group B ( n = 40). In group A the loading dose was fentanyl 0.05 mg and in group B lornoxicam 4 mg. PCIA included a background infusion at 2 ml ? h-1 and a bolus of 0.5 ml with a 15 min lock-out. VAS (0 = no pain, 10 = worst pain) was used to measure pain intensity In addition to BP, HR and SpO2 monitoring ECG was continuously monitored with a Holler monitor after operation Blood samples were taken from peripheral vein before and 6h after operation and on the 1st, 2nd, 7th and 8th postoperative days for determination of the expression of CD62p, CD63 and CD41/CD61 on the platelet membrane, platelet count, prothrombin time ( PT) thrombin time (TT) and partial thromboplastin time (PTT) Results The two groups were comparable with respect to sex, age, body weight, severity of CAD, duration of operation and intraoperative blood loss. The patients received no blood transfusion during operation. There was no significant difference in VAS score, platelet count, PT, TT and PIT between the two groups. The incidence of atrial and ventricular premature beat on ECG and the expression of CD41 /CD61 , CD62P and CD63 on the platelet membrane were significandy lower in group B than in group A on the 7th and 8th postoperative days (P
