高乌甲素复合舒芬太尼用于老年患者胃癌术后静脉自控镇痛

The effect of postoperative analgesia with lappaconitine combined with sufentanil in elder gastric cancer patients

目的观察高乌甲素复合舒芬太尼用于老年胃癌患者术后静脉自控镇痛（PCIA）的效果。方法60例年龄65～70岁，ASAⅠ或Ⅱ级，择期在全身麻醉下行胃癌根治术的患者随机均分为：A组，舒芬太尼150ug＋格拉司琼3mg；B组，高乌甲素48mg＋舒芬太尼100μg＋格拉司琼3mg；C组，高乌甲素48mg＋舒芬太尼150μg＋格拉司琼3mg。观察并记录三组患者术后6h（T1）、12h（T2）、24h（T3）、48h（T4）疼痛、镇静评分、术后48h内PCIA泵有效按压次数和术后不良反应的发生情况。结果与A组比较，T2～T4时B、C组VAS评分降低（P〈0．05），T1～T4时PCIA泵有效按压次数减少（P〈0.05），T1～T3时B组Ramsay镇静评分降低（P〈0．05）；与C组比较，T1～T3时B组Ramsay镇静评分降低（P〈0.05），三组患者均未出现明显不良反应。结论高乌甲素复合舒芬太尼可为老年胃癌患者提供良好的术后镇痛效果，不良反应少。

Objective To observe the effect of postoperative analgesia with lappaconitine combined with sufentanil in elder gastric cancer patients. Methods Sixty general anesthesia patients （ASA Ⅰ or Ⅱ grade, 65 to 70 years） undergoing selective gastric cancer surgery were randomly divided into there groups. The postoperative analgesics were sufentanil 150 μg＋granisetron 3 mg （group A）, lappaconitine 48 mg＋sufentanil 100 μg＋granisetron 3 mg（group B）, or lappaconitine 48 mg＋sufentanil 150μg-bgranisetron 3 mg（group C）. The visual analog scores of postoperative pain and sedation, the total number of pressing times within 48 h, and the incidence of adverse reactions 6 h（T1）,12 h（T2）,24 h（T3）, and 48 h（T4） postoperatively were recorded. Results Compared with group A, VAS scores decreased within T2 T4 （P〈0. 05） and the number of pressing times reduced within T1-T4 in group B and C（P%0. 05）. Compared with group C, the sedation score was lower within T1-T3 in group B （P〈0. 05）. There was no significant adverse reaction in three groups. Conclusion Lappaconitine combined with sufentanil can provide good postoperative analgesia for elderly gastric cancer patients with less adverse events.