老年患者舒芬太尼术后静脉自控镇痛

目的观察老年患者舒芬太尼术后静脉自控镇痛的镇痛效果及副反应发生率,以获得老年患者术后静脉自控镇痛的最佳剂量。方法选择择期胃肠道、腹部大手术病人,ASAⅠ~Ⅱ级,术前检查无心、肺、肝、肾功能明显异常者。随机分为两组,每组30例。A组年龄60~74岁,其中男15例,女15例;B组年龄60~75岁,其中男18例,女12例。A组术后镇痛用药剂量舒芬太尼1.0μg/kg,B组1.5μg/kg。PCIA持续剂量2.0 mL/h,PCA 0.5 mL,锁定时间15 min,术后2、4、8、16、244、8 h双盲对照观察各组视觉模拟评分(VAS),Ramsay评分、满意度评分及恶心、呕吐等不良反应发生情况。结果两组之间镇痛效果无差异(P>0.05),镇静效果有差异(P<0.05)。结论舒芬太尼对老年人产生的镇痛作用较强,且作用时间延长;老年患者舒芬太尼术后镇痛的用药剂量应相应减少。

Sufentanil in PCIA in Patients of Old Ages

Objective To investigate the effect of analgesia and side - effect of sufentanil in PCIA and select the perfect dosage in patients of old ages. Methods Patients underwent gastrointesinal and abdominal surgery was divided into two groups according to age. Group A age of 60 - 74 years old, Group B age of 60 - 75 years old, A received sufentanil 1.0 μg/kg, B 1.5 μg/kg. PCIA included bolus of 0.5 mL with lock time 15 rain and background 2.0 mL/h, the analgesia effects was evaluated by visual analgesia scales, Ramsay scales and patient satisfied scales. Side - effects such as nausea and vomiting were also recorded. Results The effect of of analgesia in the two groups has no difference （ P 〉 0.05）. The effect of sedation in the two groups has difference （ P 〈 0.05）. Conclusion Sufentanil can produce strong and lasting effect of analgesia in the old patients. The dosage of sufentanil in PCIA in the old patients of should be decreased in correspondence.