地佐辛联合曲马多用于老年患者术后静脉镇痛的临床效果观察

目的比较术后应用等效剂量地佐辛和芬太尼联合曲马多进行老年患者静脉自控镇痛（patient controlintrave—nousanalgesia，PCIA）的临床效果和安全性。方法91例择期全麻下腹部手术患者，随机分为地佐辛联合曲马多组（D组）和芬太尼联合曲马多组（F组），分别接受静脉镇痛。观察并记录患者的生命体征、疼痛评分（视觉模拟评分法visual anagloguescale，VAS）、镇静评分（Ramsay）及不良反应。结果麻醉苏醒后同时点两组VAS没有明显差异．但两组内比较2h、4h、8h、24h、48hVAS较麻醉苏醒后明显下降（P〈0．05）；PCA次数两组差异无统计学意义（P〉0．05）：F组患者在术后，112、T4、T8、T24、T48的呼吸次数明显少于D组（P〈0．05）；不良反应发生率两组比较无统计学意义。结论地佐辛联合曲马多用于老年患者腹部手术术后静脉镇痛效果确切：对于呼吸影响小、循环干扰小，适合老年患者。

Comparison of clinical effect of intravenous dezocine combined with tramadol on elderly patient control intravenous analgesia

Objective To evaluate the effect and safety of the intravenous equivalent doses of dezocine combined with tramadol for postoperative pain in old patients after abdominal surgery.Methods All of 91patients with ASAⅠ～Ⅱundergoing general anesthesia operation were divided into two groups randomly.The equivalent doses of Dezocine and Fentanyl mixed with Tramadol were applied to the patient control intravenous analgesia.The analgesic effect was evaluated by visual anaglogue scale(visual anaglogue scale,VAS),and Ramsay at 2,4,8,24,48 hours after operations.The changes of vital sign and side effect were also assessed.Results There was no significant difference between two groups in analgesia effect,and the VAS was higher in two groups when patients were awake(P<0.05).The rate of bolus was not significantly difference between two groups.The rate of breath changed after using PCIA,especially in group F.There was not significant difference in adverse reaction incidence rate.Conclusion The effect of Intravenous dezocine combined with tramadol for postoperative pain is better and affect small on breath and circulation,is fit for elderly patients.