中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
z2期
14-16
,共3页
舒芬太尼%地佐辛%术后镇痛%老年患者%关节置换
舒芬太尼%地佐辛%術後鎮痛%老年患者%關節置換
서분태니%지좌신%술후진통%노년환자%관절치환
Sufentanil%Dezocine%Postoperative analgesia%Elderly patient%Arthroplasty
目的 观察老年患者下肢关节置换手术后舒芬太尼联合地佐辛静脉镇痛的疗效与安全性.方法 选择60例ASA分级Ⅱ～Ⅲ级择期行膝髋关节置换术的老年(年龄≥65岁)患者,按随机数字表法分为Ⅰ、Ⅱ、Ⅲ组,每组20例,镇痛泵配方分别为舒芬太尼+氟哌利多、舒芬太尼+地佐辛+氟哌利多、舒芬太尼+氟哌利多(联合地佐辛肌肉注射).各组镇痛泵的背景输注量2ml/h,视觉模拟评分(VAS)＞5肌肉注射哌替定75 mg.观察各组术后6、12、24 h VSA评分、Ramsay评分、不良反应发生率及术后额外镇痛药用量.结果 三种配方均能为患者提供良好的术后镇痛.Ⅱ组的VSA评分和不良反应发生率优于Ⅰ、Ⅲ组,Ⅲ组术后6 h Ramsay评分明显高于Ⅰ组和Ⅱ组(P＜0.05),术后需额外镇痛患者数也明显多于其他两组(P＜0.05).结论 舒芬太尼联合地佐辛用于老年患者膝髋关节置换术后镇痛可提高术后镇痛质量,减少阿片类药物的用量,减少术后不良反应的发生率,值得临床应用.
目的 觀察老年患者下肢關節置換手術後舒芬太尼聯閤地佐辛靜脈鎮痛的療效與安全性.方法 選擇60例ASA分級Ⅱ～Ⅲ級擇期行膝髖關節置換術的老年(年齡≥65歲)患者,按隨機數字錶法分為Ⅰ、Ⅱ、Ⅲ組,每組20例,鎮痛泵配方分彆為舒芬太尼+氟哌利多、舒芬太尼+地佐辛+氟哌利多、舒芬太尼+氟哌利多(聯閤地佐辛肌肉註射).各組鎮痛泵的揹景輸註量2ml/h,視覺模擬評分(VAS)＞5肌肉註射哌替定75 mg.觀察各組術後6、12、24 h VSA評分、Ramsay評分、不良反應髮生率及術後額外鎮痛藥用量.結果 三種配方均能為患者提供良好的術後鎮痛.Ⅱ組的VSA評分和不良反應髮生率優于Ⅰ、Ⅲ組,Ⅲ組術後6 h Ramsay評分明顯高于Ⅰ組和Ⅱ組(P＜0.05),術後需額外鎮痛患者數也明顯多于其他兩組(P＜0.05).結論 舒芬太尼聯閤地佐辛用于老年患者膝髖關節置換術後鎮痛可提高術後鎮痛質量,減少阿片類藥物的用量,減少術後不良反應的髮生率,值得臨床應用.
목적 관찰노년환자하지관절치환수술후서분태니연합지좌신정맥진통적료효여안전성.방법 선택60례ASA분급Ⅱ～Ⅲ급택기행슬관관절치환술적노년(년령≥65세)환자,안수궤수자표법분위Ⅰ、Ⅱ、Ⅲ조,매조20례,진통빙배방분별위서분태니+불고리다、서분태니+지좌신+불고리다、서분태니+불고리다(연합지좌신기육주사).각조진통빙적배경수주량2ml/h,시각모의평분(VAS)＞5기육주사고체정75 mg.관찰각조술후6、12、24 h VSA평분、Ramsay평분、불량반응발생솔급술후액외진통약용량.결과 삼충배방균능위환자제공량호적술후진통.Ⅱ조적VSA평분화불량반응발생솔우우Ⅰ、Ⅲ조,Ⅲ조술후6 h Ramsay평분명현고우Ⅰ조화Ⅱ조(P＜0.05),술후수액외진통환자수야명현다우기타량조(P＜0.05).결론 서분태니연합지좌신용우노년환자슬관관절치환술후진통가제고술후진통질량,감소아편류약물적용량,감소술후불량반응적발생솔,치득림상응용.
Objective To evaluate the effects of intravenous analgesia with dezocine combining sufentanil in hip and knee arthroplasty for elderly patients.Methods Ninety patients with ASA Ⅱ ～ Ⅲ and aged ≥ 65 years who were scheduled for hip and knee arthroplasty under CSEA and treated with intravenous analgesia post-operation were selected and divided into three group (20 cases):group Ⅰ (sufentanil 2.5μg/kg + droperidol 2.5 mg),group Ⅱ (sufentanil 2.0 μ g/kg + dezocine 10 mg + droperidol 2.5 mg) and group Ⅲ (intramuscular dezocine 10 mg and sufentanil 2.0 μ g/kg + droperidol 2.5 mg),which were diluted to be 100 ml by adding saline.VSA,Ramsay score as well as side effects were recorded at 6,12 and 24 h after operation.75 mg meperidine was administered intramuscularly as rescue medication when VAS was above 5.Results Compared with group Ⅰ and Ⅲ,group Ⅱ showed better outcomes regarding to the VAS and less side effects.Ramsay score 6 h after operation and the amount of patients who needed meperidine in group Ⅲ were higher than those in the other two groups (P ＜ 0.05).Conclusion Dezocine combining with sufentanil in elderly patients underwent low limb arthroplasty shows better postoperative analgesia effects with less side effects,and it's worth for clinical application.
