地佐辛联合氟比洛芬酯用于老年髋关节置换患者术后镇痛的临床研究

Clinical application of dezocine combined with flurbiprofen axetil in elderly patients undergoing hip joint replacement surgery

目的观察地佐辛联合氟比洛芬酯用于老年髋关节置换患者术后镇痛效果。方法将60例拟施髋关节置换的老年(年龄>60)患者随机分为地佐辛联合氟比洛芬酯镇痛组(D组)和舒芬太尼镇痛组(SF组),每组30例。手术结束前30 min D组缓慢静注地佐辛5 mg+氟比洛芬酯50 mg,SF组静脉缓慢推注舒芬太尼0.5μg/kg,术后两组均用患者自控静脉镇痛(PCIA)。观察并记录患者术后2、4、8、24、48 h的VAS疼痛评分、Ramsay镇静评分,以及术后24 h不良反应。结果两组术后各时点安静状态VAS评分及Ramsay镇静评分差异均无统计学意义,翻身和深呼吸等活动时D组各时点VAS评分均低于SF组(P<0.05);恶心、呕吐、嗜睡等不良反应D组显著低于SF组(P<0.05)。结论地佐辛联合氟比洛芬酯用于老年髋关节置换手术的术后镇痛安全有效而且不良反应小,值得临床推荐。

Objective To observe dezocine combined with flurbiprofen axetil for elderly patients after hip replacement analgesic effect. Methods Sixty elderly （age 〉 60） patients scheduled for hip replacement surgery were randomly divided into dezocine combined with flurbiprofen axetil analgesia group （group D） and sufentanyl group （group SF）, as 30 patients for each group. Group D in 30 minites before surgery end was administrated intravenous dezocine 5 mg plus flurbiprofen axetil 50 mg, and group SF was administrated fentanyl 0.5 μg/kg. After surgery the patients in both groups were administrated with PCIA analgesia. The VAS pain score, Ramsay sedation score in 2, 4, 8, 24, 48 h, and the adverse drug reactions （ADRs） within 24 h were observed and recorded. Results The postoperative VAS scores at each time point and the resting state Ramsay sedation score difference were not statistically significant. During motion activity and taking a deep breath the VAS scores of group D at each time point were lower than group SF （P〈0.05）. Nausea, vomiting, drowsiness and other ADRs in group D were significantly lower than in group SF （P〈0.05）. Conclusion Dezocine combined with flurbiprofen axetil for elderly hip replacement surgery is safe and effective postoperative analgesia.