老年髋关节置换患者术后镇痛方案研究  

Study on postoperative analgesia in the elderly patients receiving hip replacement

作　　者：宋海明[1] 马靖华[1] 

机构地区：[1]唐山市第二医院麻醉科,河北省唐山市063000

出　　处：《实用老年医学》2016年第1期31-33,共3页Practical Geriatrics

摘　　要：目的探讨老年髋关节置换术后最佳镇痛方案。方法选取在我院行髋关节置换手术的老年患者400例作为研究对象,随机分为A、B、C、D组,每组100例。镇痛方案:A组采用0.6 mg/kg地佐辛,B组采用0.3 mg/kg地佐辛联合1.0μg/kg舒芬太尼,C组采用0.3 mg/kg地佐辛联合1.5μg/kg舒芬太尼,D组采用0.3mg/kg地佐辛联合2.0μg/kg舒芬太尼。记录患者手术后1 h、4 h、8 h、12 h、1 d以及2 d的疼痛视觉模拟评分法(VAS)评分,镇痛药物使用总量,补用镇痛药物患者的例数和不良反应的发生情况。结果 C组患者使用镇痛药物的总量和补用镇痛药物患者的例数最少;C和D组患者在术后1 h、4 h以及8 h的疼痛VAS评分明显低于A和B组,差异有统计学意义(P<0.05)。D组患者恶心、出汗、尿潴留的发生率明显高于其他组,C组患者不良反应的发生率较低。结论 0.3 mg/kg地佐辛联合1.5μg/kg舒芬太尼用于老年髋关节置换患者术后镇痛的效果较好,不良反应少。Objective To investigate the best postoperative analgesia plan for the elderly patients receiving hip replacement. Methods 400 aged patients undergoing hip replacement surgery were randomly divided into group A,group B,group C and group D,with 100 cases in each group. Group A was given 0. 6 mg / kg dezocine analgesia,while group B receiving 0. 3 mg / kg dezocine combined with 1. 0 g / kg sufentanil,group C receiving 0. 3 mg / kg dezocine combined with 1. 5 μg / kg sufentanil,group D receiving 0. 3 mg / kg dezocine combined with 2. 0 μg / kg sufentanil. VAS scores of the 1 h,4 h,8 h,12 h,1d and 2 d after the surgery,the total usage of analgesic drugs,the number of cases receiving remedial analgesic therapy and the incidence of adverse reactions were recorded and compared among four groups.Results The total usage of sufentanil and dezocine,the number of cases receiving remedial analgesic therapy were the lowest in group C; The VAS scores of 1 h,4 h and 8 h after the surgery of the group C and D were significantly lower than those of group A and group B（ P 〈0. 05）. But the incidence of nausea,sweating,urinary retention of group D was significantly higher than those of the other groups. Conclusions 0. 3 mg / kg dezocine combined with 1. 5 μg / kg sufentanil can be used in the elderly patients receiving hip joint replacement for postoperative analgesia,with better effect,and less adverse reactions.

关 键 词：髋关节置换 镇痛 地佐辛 舒芬太尼 

分 类 号：R687.4[医药卫生—骨科学]