不同剂量舒芬太尼用于老年骨科病人术后自控镇痛的临床观察  

Clinical abservation of different doses of sufentanil for controlled analgesia of elderly orthopaedic patient after operation

作　　者：张佑民[1] 沈云[1] 

机构地区：[1]安徽省来安县人民医院麻醉科,安徽来安239200

出　　处：《安徽医药》2014年第4期742-744,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨不同剂量舒芬太尼用于老年骨科病人术后自控镇痛的临床效果。方法选取2011年6月—2012年5月该院收治的老年骨科病人90例进行分析,随机分成A、B、C三组,各30例,三组均采用0.125%的布比卡因进行术后自控镇痛,A组辅以舒芬太尼0.25μg·kg^(-1),B组辅以舒芬太尼0.5μg·kg^(-1),C组辅以舒芬太尼0.75μg·kg^(-1),观察三组术毕和术后2、8、12、24 h疼痛评分、镇静评分以及运动阻滞评分和不良反应发生率。结果三组各时间点疼痛评分均较低,比较差异无统计学意义(P>0.05);各时间点镇静评分上A组明显低于B、C组(P<0.05),而B组和C组在术后8 h存在显著差异(P<0.05),在其余时间点差异无统计学意义(P>0.05);三组均无呼吸抑制发生,C组皮肤瘙痒发生率明显高于A组和B组(P<0.05),三组在运动阻滞评分和恶心呕吐发生率上差异无统计学意义(P>0.05)。结论采用0.5μg·kg^(-1)舒芬太尼复合布比卡因用于老年骨科病人术后自控镇痛能够起到良好的镇痛和镇静效果,不良反应发生少,患者术后骨关节功能恢复快,效果显著。Abstract：Objective To study clinical effect of different close of sufentanil on controlled analgsia of elderly orthopaedic patient after operation. Methods 90 cases of elderly orthopaedic patients admitted to hospital from June 2011 to May 2012 were analyzed, and randomly divided into three groups, each group 30 cases. Group A was administered with 0.25 μg· kg^-1, group B with 0.5 μg· kg^-1, group C 0. 75 μg· kg^-1, We observed pain scores, sedation score, motor block score and adverse reaction incidence right after the operation and postoperative 2 h, 8 h, 12 h, 24 h. Results Pain scors at all time points in group A were significantly higher than those in group B and C（ P 〈 0.05 ）. Between group B and group C pain scores at 8 h and 12 h after surger exist significant difference （P 〈 0.05 ） ;Sedation scores at all time points in group C were significantly higher than those in group A and group B （ P 〈 0.05 ） , whereas between group A and group B at postoperative 8 h there existed significant differences （ P 〈 0. 05 ） ; Incidence of itchy skin of group A was significantly higher than those of group B and group C （ P 〈 0. 05 ）. There were no statistically significant difference in the sports block grading and incidence of nausea and vomiting among the there groups （ P 〉 0. 05 ）. Conclusions Use of 0.5 μg· kg^-1 sufentanil for controlled analgesia of elderly orthopaedic patient can play a good postoperative analgesia and sedative effect, which leads to less ad- verse reactions and remarkable effect.

关 键 词：老年 骨科 术后自控镇痛 舒芬太尼 布比卡因 

分 类 号：R614[医药卫生—麻醉学]