喷他佐辛与芬太尼在老年患者开胸术后的镇痛效应比较  

Effects of pentazocine and fentanyl on analgesia after thoracotomy in elderly:A comparative study

作　　者：肖金仿[1] 刘高望[1] 唐建军[1] 古妙宁[1] 肖伦华[1] 

机构地区：[1]南方医科大学南方医院麻醉科,广州510515

出　　处：《广东医学》2010年第10期1225-1227,共3页Guangdong Medical Journal

摘　　要：目的观察喷他佐辛与芬太尼在老年患者胸腔镜辅助下开胸术后静脉自控镇痛(PCIA)的临床效果和不良反应,探讨其有效性及安全性。方法选择胸腔镜辅助下开胸术后患者60例(ASAⅠ～Ⅱ级),随机分为P组和F组两组(n=30),P组予喷他佐辛180mg+阿扎司琼20mg镇痛液180mLPCIA,F组予芬太尼1.8mg+阿扎司琼20mg镇痛液180mLPCIA。两组PCIA均采用负荷剂量5mL,持续输注剂量2.5mL,PCA追加剂量2.5mL,锁定时间为15min的镇痛模式。记录麻醉诱导前及术后心率(HR)、平均动脉压(MAP)和脉搏氧饱和度(SpO2)、呼吸(RR)、潮气量(VT)、分钟通气量(MV)、呼气末二氧化碳分压(PETCO2)的变化;术后患者的镇痛满意度、Prince-Henvy镇痛评分以及不良反应。结果两组患者HR、MAP、SpO2、RR、VT、MV、PETCO2在麻醉诱导前(0min)及拔管后0、2、4、8、16、24h组间比较差异无显著性(P>0.05);患者各时段按压次数(D1)和有效按压次数(D2)比较差异无显著性(P>0.05)。术后镇痛满意度、Prince-Henvy镇痛评分比较差异无显著性(P>0.05)。P组和F组恶心、呕吐分别为2例(6.7%),1例(3%);P组和F组皮肤瘙痒分别为0例,1例(3%);未见呼吸抑制、低血压眩晕、心动过缓等不良反应病例。结论喷他佐辛与芬太尼对老年患者胸腔镜辅助下开胸术后静脉自控镇痛临床效果相似,安全有效。Objective To study the clinical effects and safety of pentazocine and fentanyl on patient -controlled analgesia （PCA） after thoracotomy assisted with thoracoscopy in elderly patients. Methods Sixty elderly patients （ASA Ⅰ -Ⅱ ） with thoracotomy receiving PCIA were enrolled and randomly divided into group P （pentazocine） and group F （ fentanyl ）. Pentazocine and fentanyl were used in combination with azasetron for the treatment of postoperative analgesia in the two groups, respetively. Heart rate （HR）, mean arterial pressure （MAP）, pulse oxygen saturation （SpO2 ）, re- spiratory （RR）, tidal volume （TV）, minute ventilation （MV） and carbon dioxide partial pressure （PCO2） were recorded before and after induction of anesthesia. Meanwhile, postoperative patient satisfaction, analgesic effect and adverse reac- tions were also recorded. Results There was no significant difference in HR, MAP, RR, Sp02, VT, MV and PCO2 at all time spots between group P and F （ P 〉 O. 05 ）. Tthe number of compression （ D1 ） and effective compression （ D2 ） presented no significantly difference （P 〉 0.05）. There was no significant difference in satisfaction with postoperative an- algesia and analgesic effect （P 〉 O. 05 ）. Two （6. 7% ） and one （3 % ） patients presented nausea and vomiting in Group P and F, respectively. One case of pruritus was reported in Group F, while no pruritus was reported in Group P. No respira- tory suppression, low blood pressure dizziness, bradycardia and other complications were reported in the study. Conclu- sion Pentazocine is similar to fentanyl in the clinical efficacy and has fewer adverse reactions in the patient - controlled analgesia （PCA） after thoracotomy assisted with thoracoscopy in elderly patients.

关 键 词：喷他佐辛 芬太尼 老年人 胸腔镜 自控镇痛 

分 类 号：R971.1[医药卫生—药品]