不同给药途径地佐辛复合芬太尼对老年骨科患者术后的镇痛效果研究

Effect of dezocine and fentanyl given by different administration routes on elderly orthopedic patients

目的:分析不同给药途径地佐辛复合芬太尼对老年骨科患者术后的镇痛效果。方法:选择接受手术治疗的骨科老年患者186例,给予地佐辛复合芬太尼进行术后镇痛,根据给药途径不同随机将其分为对照组和观察组,每组93例;对照组采用静脉给药,观察组采用硬膜外给药。检测两组患者镇痛前后的视觉模拟评分(VAS)、应激反应以及并发症发生率情况。结果:1镇痛治疗后,两组患者的平均VAS均低于镇痛前,且观察组患者的镇痛1 d、镇痛2 d的平均VAS评分明显低于对照组;2镇痛后,观察组患者的平均血压、心率、内皮素(ET)、心房钠尿肽(ANP)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)水平均低于对照组;3镇痛治疗后,观察组患者的恶心呕吐、头晕、便秘及呼吸抑制等总并发症发生率明显低于对照组。结论:对骨科老年患者术后使用地佐辛复合芬太尼硬膜外镇痛,可以有效减轻其疼痛感受、降低机体应激水平、减少并发症的发生。

Objective： To analyze the effect of dezocine and fentanyl given by different administration routes on elderly orthopedic patients. Methods： The elderly patients received surgery in our hospital from October 2012 to October 2013 were enrolled and given dezocine combined with fentanyl for postoperative analgesia. Then patients were randomly divided into control group given injection by intravenous and observation group given injection by epidural administration, each group with 93 cases and analgesia VAS pain score, stress response and the incidence of complications situation were observed. Results： 1）After analgesic treatment, both groups＇ average VAS pain scores were lower than before, and the observation group＇s analgesic one day, two days average VAS pain scores were significantly lower than the control group; 2）After analgesia the observation group＇s ET, ANP, Cor, ACTH levels were lower than the control group; 3）After analgesic, observation groups＇ nausea, vomiting, dizziness, constipation, respiratory depression overall complication rate was significantly lower than the control group. Conclusion： The use of dezocine fentanyl epidural analgesia can effectively reduce elderly patients perception of pain, reduce body stress levels, reduce the incidence of complications.