喷他佐辛复合舒芬太尼在老年人胸腔镜术后镇痛的应用

Application of Pentazocine Combined with Sufentanil in Post-thoracoscopy Analgesia for Aged Patients

目的:探讨喷他佐辛复合舒芬太尼在老年人胸腔镜肺叶切除术后经静脉自控镇痛的安全性、有效性。方法:90例胸腔镜下单侧肺叶切除术的老年肺癌患者,随机分为喷他佐辛组(A组)、舒芬太尼组(B组)和喷他佐辛复合舒芬太尼组(C组)三组。记录患者的视觉模拟评分(VAS)、布氏舒适评分(BCS)、Ramsay镇静评分,及静脉自控镇痛泵按压次数与不良反应。结果:给药后6 h内B组和C组患者的VAS法评分明显优于A组,差异有统计学意义(P<0.05);BCS法镇痛评分中各时间点B组和C组明显优于A组,差异有统计学意义(P<0.05);Ramsay镇静评分比较,C组和A组给药后24 h内Ramsay镇静评分明显优于B组;给药48 h内P组患者PCIA电子泵实际按压次数和有效按压次数显多于B组与C组。在不良反应方面,A组和C组的患者恶心与呕吐、嗜睡发生率明显低于B组,差异有统计学意义(P值均<0.05)。结论:喷他佐辛复合舒芬太尼是老年患者胸腔镜肺叶切除术后镇痛一个安全、有效的选择。

Objective To explore the safety and effectiveness of pentazocine combined with sufentanil in patient-controlled intravenous analgesia after thoracoscopy for aged patients. Method 90 aged patients with lung cancer underwent thoracoscopic unilateral pulmonary lobectomy. They were randomly divided into three groups：pentazocine（ group A）,sufentanil（ group B） and pentazocine combined with sufentanil（ group C）. Visual analogue scale（ VAS）,Bruggrmann comfort scale（ BCS）,Ramsay sedation score,PCIA demand times and adverse reactions of these three groups were recorded. Results The VAS scores of group B and group C six hours after administration,were much higher than that of group A（ P〈 0. 05）. The BCS scores of group B and group C at different points were much better than that of group A（ P 〈0. 05）. The Ramsay sedation scores of group C and group A within twenty-four hours after administration were obviously higher than that of group B. The PCIA demand times and effective demand times of group A within fourty-eight hours after administration were significantly higher than those of group B and group C. In terms of adverse reactions,the incidence rates of nausea,vomiting and drowsiness of group A and group C were much lower than those of group B（ P 〈0. 05）. Conclusion Pentazocine combined with sufentanil is a safe and effective option for post-thoracoscopy analgesia for aged patients.