摘要
目的评价地佐辛复合氯诺昔康用于老年患者人工股骨头置换术后的镇痛效果。方法将50例美国麻醉医师学会(ASA)分级Ⅰ或Ⅱ级行人工股骨头置换术的老年患者随机分入地佐辛复合氯诺昔康组和舒芬太尼组,每组25例。地佐辛复合氯诺昔康组给予地佐辛15mg+氯诺昔康16mg行患者静脉自控镇痛(PCIA),舒芬太尼组给予舒芬太尼200μg行PCIA,两组镇痛药物均以0.9%氯化钠溶液稀释至100mL。手术结束前30min连接镇痛泵,设定PCIA泵的负荷剂量2mL、持续剂量2mL/h,患者自控镇痛(PCA)剂量0.5mL,锁定时间20min。在术后1、4、8、12、24、48h各时间点,记录患者的疼痛视觉模拟评分(VAS评分)、Ramsay镇静评分。记录PCA按压总次数和有无恶心呕吐等不良反应发生。结果两组患者术后均未使用曲马多。两组间在术后各时间点的疼痛VAS评分和Ramsay镇静评分的差异均无统计学意义(P值均>0.05),地佐辛复合氯诺昔康组恶心呕吐的发生率显著低于舒芬太尼组(P<0.05)。结论地佐辛复合氯诺昔康用于老年患者人工股骨头置换术后镇痛安全有效。
Objective To evaluate the effectiveness of dezocine combined with Iornoxicam for patient- controlled intravenous analgesia （PCIA） in elderly patients undergoing artificial femoral head replacement. Methods Fifty elderly patients, American Society of Anesthesiologists （ASA） grade Ⅰ or Ⅱ, scheduled for artificial femoral head replacement were randomly assigned to dezocine group （dezocine 15 mg ＋ Iornoxicam 16 mg, n =25） and sufentanil group （sufentanil 200 μg, n =25）. Drugs were diluted with normal saline to prepare 100 mL solution. Thirty minutes before the end of operation, PCIA pump was set up with a bolus of 2 mL, patient- controlled analgesia （PCA） volume 0.5 mL and lockout interval 20 min with a background infusion 2 mL/h. Visual analogue scale （VAS） score, Ramsay score, PCA frequency and adverse effects were recorded at 1, 4, 8, 12, 24 and 48 h after surgery. Results No patients took tramadol. There was no significant difference in the VAS score or Ramsay score between two groups （all P〈0.05）. The incidence of nausea and vomiting in dezocine group was significantly lower than that in sufentanil group （P〈0.05）. Conclusion Administration of dezocine combined with Iornoxicam is effective and safe in postoperative analgesia after artificial femoral head replacement in elderly patients.
出处
《上海医学》
CAS
CSCD
北大核心
2013年第6期514-516,共3页
Shanghai Medical Journal
关键词
地佐辛
氯诺昔康
镇痛
老年
人工股骨头置换
Dezocine
Lornoxicam
Analgesia
Elderly
Artificial femoral head replacement
