59例外科ICU高龄手术患者镇痛药物使用分析

Analysis of analgesic drugs used in 59 elderly surgical ICU inpatients

目的:调查外科ICU高龄患者术后镇痛药物使用现状。方法:依据患者住院病历,回顾性收集2013年外科ICU手术后3天内,使用过镇痛镇静药物的高龄(年龄≥65岁)住院患者用药等相关信息,并对数据进行整理、分析和归纳。结果:共入选合格患者59名,入选患者人数前三位的科室为心脏外科、胸外科和骨科,分别占总人数的27.6%,22.4%和19.8%。59名患者中,约45.2%的患者术后仅使用了阿片类药物,14.2%的患者术后仅使用了非阿片类药物,还有约40.6%的患者术后联合使用了阿片类和非阿片类药物。术后患者自控镇痛(Patient-controlled analgesia,PCA)的使用率为58.1%。术后镇痛药物不良反应发生率是10.1%,主要是阿片类药物引起的恶心和呕吐。结论:临床药师需要经常判断患者镇痛镇静程度,并随时调整药物种类与剂量,改善高龄患者术后疼痛。

Objective：To investigate the situation of analgesic medication used in eder patients in the ICU after surgery.Methods：Based on the medical records,the information of elder inpatients（age≥65years）underwent analgesics 3days after surgery from ICU in 2013 were collected to analyze.Results：59patients were selected,and the first three departments in which these patients enrolled were cardiac surgery,thoracic surgery and orthopedics,taking part in 27.6%,22.4%and 19.8%of total patients,respectivly.45.2%of the patients used only opioids,14.2%of the patients used only non-opioids,and 40.6%patients used both.PCA utility was58.1%,and the adverse drug reaction was 10.1%.Most of the ADR were opioid-induced nausea and vomiting.Conclusion：Clinical pharmacists need to determine the degree of the sedation,and adjust the type and dosage of the drugs to improve the pain management in elder patients.