舒芬太尼在老年全髋关节置换术后静脉自控镇痛的临床应用

Application of patient controlled intravenous analgesia with sufentanil after total hip replacement in aged patient

目的 观察老年患者全髋关节置换术后舒芬太尼脉自控镇痛的临床效果和安全性,并和芬太尼静脉自控镇痛比较.方法 硬膜外麻醉下全髋关节置换术后老年患者60例,随机分为研究组（n=30）和对照组（n=30）,前者使用舒芬太尼,对照组使用芬太尼,两组均加昂丹司琼4 mg,均以0.9%生理盐水稀释至100 ml.观察术后镇痛效果与不良反应.结果 研究组VAS在术后48h内低于对照组（P〈0.05）;收缩压对照组明显高于研究组（P〈0.05）,不良反应的发生率亦较研究组高（P〈0.05）.结论 舒芬太尼可安全有效地用于老年全髋关节置换术后静脉自控镇痛,效果优于芬太尼,且不良反应减少.

Objective To investigate and compare the effect and safety of patient-controlled intravenous analgesia with sufentaniI and fentanyl in elderly patients after total hip replacement. Methods Sixty aged patients under epidural anesthesia after total hip replacement were randomly divided into 2 groups： research group （n=30） and control group （n=30）. The patients in research group were received sufentanil and ondansetron, in the control group received fentanyl and ondansetron, and diluted with 0.9% normal saline to 100ml. The postoperative analgesic effect and adverse reaction were observed. Results VAS was lower in research group than that in the control group （P 〈0.05） in 48 h after the operation, while SBP was higher than that in research group （P〈0.05）, the incidence of adverse reactions was higher in control group than that in the research group （P〈 0.05）. Conclusion Patient controlled intravenous analgesia with sufentanil is effective and safe in elderly patients after total hip replacement, the effect is better than that of fentanyl, and adverse reaction is less.