舒芬太尼复合氯诺昔康在老年人胸部手术后静脉自控镇痛应用.docVIP

舒芬太尼复合氯诺昔康在老年人胸部手术后静脉自控镇痛应用【摘要】 目的 观察舒芬太尼复合氯诺昔康在老年人胸部手术后静脉自控镇痛的应用效果。方法 60例老年人普胸手术后行静脉自控镇痛，随机分为两组：A组(舒芬太尼1 μg/ml加入0.9%生理盐水稀释到100 ml,PCIA)。B组(舒芬太尼0.5 μg/ml联合氯诺昔康0.32 mg/ml加入0.9%生理盐水稀释到100 ml,PCIA)。观察术后4、8、16、24、48 h的镇痛效果、镇静评分及不良反应。结果 两组镇痛效果比较差异无统计学意义(P0.05)。镇静效果：A组镇静较强，与B组比较差异有统计学意义(P0.05)，两组均无呼吸抑制及胃出血发生。结论 老年人普胸手术后行舒芬太尼复合氯诺昔康静脉自控镇痛效果好，不良反应少。 【关键词】舒芬太尼；氯诺昔康；老年；术后镇痛 Application of sufentanil combined with lornoxicam in the elderly patients controlled intravenous analgesia after thoraces surgery YE Xiu-qing，WANG Chen，LIU Yong-qian，et al. Department of Anesthesiology，Second Hospital，Xiamen，Fujian 361021，China 【Abstract】 Objective To observe the effects of sufentanil combined with lornoxicam in the elderly patients controlled intravenous analgesia (PCIA) after thoraces surgery.Methods Sixty elderly patients scheduled for the thoraces sugery were divided randomly into two groups:sufentanil 1ug/ml in A group(n=30) and sufentanil 0.5 μg/ml plus lornoxicam 0.32 mg/ml in B group (n=30).Each drug was diluted to 100 ml and infused by an pump at a rate of 2 ml/h.The sedative scores，visual analogue scales，and side effects were recorded at 4，8，16，24，48 hour after operation.Results There were no significant differences in the potency of analgesia between the two groups.The sedative scores of group A was more obviously than group B.The incidence rate of the side effects was same in group A and B，such as nausea，vomiting，swirl，and itch of skin.There were no respiratory depression and gastrorrhagia in the two goups.Conclusion PCIA with sufentanil combined with lornoxicam was safe and effective for the elderly patients after thoraces surgery. 【Key words】Sufentanyl;Lornoxicam;Elderly;Postoperative analgesia 探讨阿片类麻醉性镇痛药舒芬太尼与非甾体类抗炎镇痛药氯诺昔康复合用于老年人胸部手术后镇痛，以减少阿片类药物的用量，降低其不良反应。 1 资料与方法 1.1 临床资料 2006年1月至2007年10月择期全麻下行前或后外侧切口的普胸外科手术的老年人60例，男40例，女20例；年龄61~85岁，平均(69.8±6.3)岁；体质量38~70kg,ASA Ⅰ~Ⅲ级。术前所有患者均了解和熟悉PCA的使用和视觉模拟评分法(VAS,0~10分,0分为无痛，10分为剧痛)。排除标准：滥用或经常服用止痛药物；有精神病或老年痴呆病史；