地佐辛联合舒芬太尼用于老年开胸患者术后镇痛的临床观察  

Clinical observation of dezocine combined with sufentanil for postoperative analgesia in elderly patients undergoing thoracic surgery

作　　者：周荣胜[1] 朱宇麟[1] 景桂霞[1] 马正敏[1] 何平[1] 毕阳[1] 

机构地区：[1]西安交通大学医学院第一附属医院麻醉科,陕西西安710061

出　　处：《现代肿瘤医学》2013年第2期414-417,共4页Journal of Modern Oncology

摘　　要：目的:观察地佐辛联合舒芬太尼用于老年开胸患者术后静脉自控镇痛(PCIA)的效果及其安全性。方法:90例ASAⅠ-Ⅱ级在全麻下行开胸手术的老年患者,随机分为地佐辛组(D组)、舒芬太尼组(S组)、地佐辛联合舒芬太尼组(DS组),每组30例。D组:地佐辛0.75mg.kg-1+托烷司琼4mg加生理盐水至100ml;S组:舒芬太尼2.5μg.kg-1+托烷司琼4 mg加生理盐水至1 0 0 ml;DS组:地佐辛0.25mg.kg-1+舒芬太尼1.25μg.kg-1+托烷司琼4mg加生理盐水至100ml。分别记录三组术后3、6、12、24和48h的镇痛VAS评分、Ramsay镇静评分,PCA泵实际、有效按压次数,并于48h后记录不良反应和镇痛总体满意度等。结果:DS组患者的VAS评分、Ramsay镇静评分显著优于D组和S组(P<0.05);术后恶心呕吐、嗜睡、呼吸抑制等不良反应明显少于D组和S组(P<0.05);PCA实际、有效按压次数少于D组和S组(P<0.05);患者的术后镇痛总体满意度高于D组和S组(P<0.05)。结论:地佐辛联合舒芬太尼用于老年开胸患者术后PCIA,能提供良好的术后镇痛效果,且不良反应少,患者的总体满意度高。Objective：To investigate the efficacy and safety of dezocine combined with sufentanil on patient controlled intravenous analgesia（PCIA） in elderly patients undergoing thoracic surgery. Methods： Ninety ASA class Ⅰ or Ⅱ elderly patients scheduled to undergoing thoracic surgery were randomly divided into 3 groups （ n = 30 each） ： dezocine（D） ,sufentanil（S） ,dezocine combined with sufentanil（DS）. Group D ： dezocine 0.75mg · kg-1 ＋ tropisetron 4 mg and physiological saline to 100 ml; Group S ： sufentanil 2.5 μg · kg- 1 ＋ tropisetron 4 mg and physiological saline to 100 ml; Group DS： dezocine 0.25mg · kg ^- 1 ＋ sufentanil 1.25 μg· kg- 1 ＋ tropisetron 4 mg and physiological saline to 100 ml. VAS score, Ramsay sedation score, number of attempts, number of successful deliveries, side - effects and the satisfaction of analgesia were recorded at 3,6,12,24 and 48h after the operation. Results：In group DS the VAS score and Ramsay score were significantly better than that in group D and S （ P 〈 0.05 ）. The side - effects （ postoperative nausea and vomiting, sleepiness, respiratory depression） in group DS was significantly lower than that in group D and S（P 〈 0.05）. The number of actual press and effective press in group DS was significantly lower than

关 键 词：地佐辛 舒芬太尼 老年 开胸手术 术后镇痛 

分 类 号：R730.56[医药卫生—肿瘤]