地佐辛用于老年患者术后自控静脉镇痛的临床研究

Clinical study of analgesic effects of dezocine used for postoperative PICA in elderly orthopaedic surgery patients

目的研究地佐辛用于骨科手术老年患者术后自控静脉镇痛(PCIA)的临床疗效。方法 80例老年骨科手术患者,ASAⅡ或Ⅲ级,随机均分为地佐辛组(D组)和舒芬太尼组(S组)。D组选用地佐辛40mg+生理盐水至100ml;S组选用舒芬太尼100μg+生理盐水至100ml。均采用PCA泵(100ml)以LCP模式(负荷剂量3ml+持续剂量2ml/h+PCA每次0.5ml)进行镇痛。观察术后4、8、20、24和48h患者VAS评分、Ramsay镇静评分,记录术后48h内患者有效PCA按压次数。结果综合镇痛质量,D组与S组差异无统计学意义;D组恶心、呕吐、皮肤瘙痒、嗜睡、呼吸抑制、低血压等发生率明显低于S组(P<0.01)。结论地佐辛、舒芬太尼PCIA用于老年骨科手术患者术后镇痛均可获得满意的效果,地佐辛较舒芬太尼的不良反应少,似乎适合老年骨科手术患者术后自控静脉镇痛。

Objective To study clinical efficacy of dezocine used for postoperative PICA in elderly orthopaedic surgery patients. Methods Eighty ASA physical status Ⅱ and Ⅲ elderly orthopaedic surgery patients were randomly divided into dezocine group （group D） and sufentanil group（group S）. Group D,40 nag dezocine＋normal saline to 100 ml; group S, 100 μg sufentanil＋ normal saline to 100 ml. Postoperative analgesia was provided by PCA pumb with LCP model（load dosage 3 ml ＋lasting dosage 2 ml ＋0. 5 ml/pertime）. Observation of VAS scroe, Ramsay sedation score at 4, 8, 20, 24 and 48 postoperatively in patients, The press times of PCA were recorded within 48 hours after surgery. Results （1） Both groups did not show any significant difference in the analgesic effects. （2）Complications as nausea, vomiting, itching, sleeping, respiratory inhibition and hypotension were higher significantly in group S than in group D（P〈0.05）. Conclusion Either dezocine or sufentanil is satisfied used for postoperative PCIA in elderly orthopaedic surgery patients, but the adverse effects are much less with dezocine than with sufentanil.