舒芬太尼与丁丙诺啡对老年骨科患者术后镇痛效果比较

Comparison of postoperative analgesia effect between sufentanil and buprenorphine on elderly orthopedic patients

目的：比较等效剂量舒芬太尼与丁丙诺啡对骨科老年病人患者术后镇痛的效果。方法选择60例ASAⅠ～Ⅱ级65～78岁的下肢骨折需行切开复位内固定术的患者，随机分为舒芬太尼组（S）和丁丙诺啡组（D），每组30例。2组均采用静脉自控镇痛（PCIA）给药，S组：舒芬太尼100μg，D组：丁丙诺啡1．2 mg，总量100 ml，术后5、10、20及40 h行VAS疼痛与Ramsay评分，记录PCA有效按压次数及不良反应发生率。结果2组VAS疼痛评分、Ramsay评分及PCA有效按压次数差异均无统计学意义，而不良反应发生率D组显著高于S组（P＜0．01）。结论等效剂量舒芬太尼与丁丙诺啡用于骨科老年病人术后镇痛效果相当，但舒芬太尼不良反应发生率较低，更适合于骨科老年病人的术后镇痛。

Objective To Compare effect of postoperative analgesia between equivalent dose of sufentanil and buprenor -phine on elderly orthopedic patients .Methods 60 cases of ASA Ⅱ-Ⅲ patients, aged 65~78 and ready for open reduction and internal fixation,were randomly divided into a sufentanil group （S） and a buprenorphine group （D）,30 cases in each one.Both were treated with intravenous patient-controlled intravenous analgesia （ PCIA） administration （ group S sufentanil 100 μg;group D buprenorphine 1.2mg, total 100ml）.After 5,10,20 and 40 hs respectively,VAS pain and Ramsay scores were graded .The number of effective PCA pressing and incidence of adverse reaction were accordingly recorded .Results The two groups had no significant statistic difference in terms of VAS pain score ,Ramsay score and PCA effective pressing number , but the incidence of adverse reactions in group D was significantly higher than that in group S （P〈0.01）.Conclusion Sufentanil and buprenorphine of equivalent dose ,if used after operation in elderly orthopedic patients ,have nearly equal analge-sia effect.But the adverse reaction rate of sufentanil is relatively lower .Thus it is more suitable for postoperative analgesia for elderly orthopedic patients .