高乌甲素复合芬太尼用于老年患者髋部手术后镇痛的临床观察  

Efficacy of iappaconitine combined with fentanyl for PCIA in elderly patients with hip surgery

作　　者：田毅[1] 柳培雨 田国刚[1] 朱坚忠[1] 

机构地区：[1]海南省海口市人民医院麻醉科,570208 [2]海南省武警总队医院麻醉科

出　　处：《实用疼痛学杂志》2009年第1期22-24,共3页Pain Clinic Journal

摘　　要：目的探讨高乌甲素用于老年患者髋部手术后静脉自控镇痛（PCIA）的安全性和临床效果。方法择期行髋部手术的老年患者60例，随机均分为2组。Ⅰ组：芬太尼0．5mg，高乌甲素16mg加昂丹司琼8mg；Ⅱ组：芬太尼1．0mg加昂丹司琼8mg。两组均用0．9％生理盐水稀释到100ml，设定持续给药量2ml／h，单次量0．5ml，锁定时间15min。观察用药后的循环与呼吸变化、视觉模拟疼痛（VAS）评分、镇静评分及48h内的患者自控镇痛（PCA）次数，并观察术后不良反应。结果两组患者术后48h内镇痛效果均满意，VAS评分、PCA次数均无统计学差异（P〉0．05）。Ⅱ组镇静评分高于Ⅰ组（P〈0．05）。Ⅱ组患者术后24及48h的呼吸频率（RF）和脉搏血氧饱和度（SpO2）明显低于A组，且不良反应的发生率显著高于A组（P〈0．05）。结论高乌甲素用于老年髋部手术后静脉镇痛是安全有效的，不良反应较少。Objective To investigate the safety and efficacy of lappaconitine combined with fentanyl for postoperative patient-controlled intravenous analgesia （PCIA） in elderly patients underwent hip surgery： Methods Sixty elderly patients undergoing hip surgery were randomly divided into two groups： group Ⅰ： fentanyl 0.5 mg, lappaconitine 16 mg, ondansetron 8 mg; Group Ⅱ： fentanyl 1.0mg, ondansetron 8 mg. The mixture in both groups were diluted with 0.9% sodium chloride to 100 ml . The basal infusion of PCA pumps was 2 ml/h, and PCA 0.5ml/15min . MAP, HR, RF and SpO2 were recorded perioperatively. The VAS, Ramsay sedation scale, PCIA pressing times within 48 hours and the adverse reactions were recorded at, 2, 4, 8, 12, 24, 48 h after surgery. Results Patients in the two groups did not show significant difference in VAS and PCIA pressing times , and the analgesic effect was satisfied. Ramsay sedation scale in group Ⅱ was significantly higher than that in group Ⅰ. RF and SpO2 at 24, 48 h after the hip surgery in group Ⅱ were distinctly lower than those in group Ⅰ , and the adverse reactions were significantly higher than that in group Ⅰ（P（0.05）. Conclusion Co-administration of lappaeonitine with fentanyl by PCIA offers favorable analgesic effects as well as the reduction of the adverse reactions in the elderly patients following hip surgery .

关 键 词：高乌甲素 疾病 老年人 关节成形术 置换 髋 镇痛 患者控制 

分 类 号：R169.42[医药卫生—公共卫生与预防医学] R473.6