地佐辛镇痛对老年骨科手术患者术后谵妄发生率的影响

目的：观察地佐辛术后静脉镇痛对老年骨科患者术后谵妄发生率的影响。方法：择期行髋关节置换术患者70例，年龄〉60岁，随机均分为地佐辛术后镇痛组（ DA组）和吗啡术后镇痛组（ MA组），各组35例。术后行患者静脉自控镇痛，并随访统计术后即刻（T1）、24 h（T2）和48 h（T3）3个时间点的谵妄发生率（CAM-CR法）、VAS评分以及术后不良反应。结果：DA组在T1的术后谵妄发生率与MA组差异无统计学意义（P〉0.05）；DA组患者术后恶心呕吐与呼吸抑制发生率与MA组的差异均无统计学意义（P〉0.05）。2组患者在T1、T2和T3三个时间点VAS评分差异均无统计学意义（P〉0.05）。结论：对于老年骨科手术患者而言，地佐辛术后静脉自控镇痛具有与吗啡相当的镇痛效果，并不增加术后谵妄的危险性，不良反应较少。

Effect of dezocine analgesia on the incidence of the postoperative delirium in orthopedic patients

Objective：To investigate the effects of dezocine analgesia on the incidence of the postoperative delirium in orthopedic elderly patients. Methods：Seventy more than 60 years old patients,who were scheduled by knee and hip arthroplasty were randomly into the dezocine analgesia group （ DA group ） and morphine analgesia group （ MA group ） （ 35 cases each group ） . The incidence of the postoperative delirium,visual analog scale（VAS） and adverse reactions between two groups were compared after operation（T1）,and at 24 and 48 hours after operation（T2 and T3）. Results：The difference of the incidence of delirium at T1 between two groups was not statistically significant（P 〉0. 05）. The differences of the incidences of nausea,vomiting and respiratory depression after operation between two groups were not statistically significant（P〉0. 05）. The differences of the VAS scores at T1,T2 and T3 between two groups were not statistically significant（P 〉0. 05）. Conclusions：The effects of dezocine analgesia on the incidence of the postoperative delirium in orthopedic elderly patients are the same as that of morphine,which are less risks and adverse reactions.