三种镇痛药物对老年胸腔镜术后的镇痛效果

目的：观察帕瑞昔布钠或地佐辛辅助舒芬对老年胸腔镜术后镇痛效果。方法：胸腔镜肺叶切除术的老年病人54例，随机分为帕瑞昔布钠组（P组）、地佐辛组（D）、舒芬太尼组（S组），每组18例。手术切皮前20minP组静注帕瑞昔布钠40mg，D纽地佐辛10mg，S纽给予2mL生理盐水。缝皮时停止麻醉药，连接舒芬静脉自控镇痛泵，记录术后1h镇静评分及术后1、4、8、12、24、48hVAS评分，记录术后48h所需舒芬的量及不良反应。结果：术后1h镇静评分P组、D组高于S组（P〈0．05），术后VAS评分1、4、8、12hP组、D组低于S组（P〈0．05）．24、48h三组无统计学意义，P与D组各时点无差异；舒芬量P组、D组低于S组（P〈0．05），三组不良反应无明显差异。结论：帕瑞昔布钠或地佐辛辅助舒芬静脉自控镇痛对老年胸腔镜术后早期疼痛都有良好的抑制作用。

THE AID EFFECTS OF THREE ANALGESIA ON THE POST-OPERATIVE ANALGESIA IN OLD PATIENT THORACOSCOPE

Objective ：To sdudy the aid effects of Parecoxib sodium or Dezocine to Sufentanil on the postoperative analgesia in old patient with thoracoscope. Methods ： 54 old cases of thoracoscope pul-monary lobectomy were divided into three groups, Parecoxib sodium group （P）, Dezocine goupr （D）, Sufentanil goupr（S）（n= 18）. Parecoxib sodium 40mg in P group ,Dezocine 10 mg,in D group and 2ml NS in S group were injected intravenously 20min before incide. The anesthesia was stoped at the time point of suture, simulteneously the intravenous PCA pump of Sufentanil was used. The sedative score was recorded lhr after operation and VAS were recorded 1、4、8、12、24、48h after operation. The doses of Sufentanil and adverse effect were recorded. Results： The sedative score of P and D groups were higher than S group after operation. The VAS of P and D groups lower than S group at the time point of 1、4、8、12h after operation（P〈0.05）. There were no significant different between P and D group about VAS at all time point after operation, and among three groups 24h and 48h after operation. The Sufentanil dosage of P and D group were lower than S group （ P〈0.05 ）, there were no significant different among the three groups about adverse effect. Conclusion： There were significant analgesia effects of Parecoxib sodium and Dezocine aiding to Sufentanil in old patient thoracoscope during early postoperation.