喷他佐辛联合罗派卡因用于老年人下肢骨科手术硬膜外镇痛的临床观察

目的观察喷他佐辛联合罗派卡因用于老年人下肢骨科手术硬膜外镇痛的临床效果。方法 100例骨科老年下肢手术患者,在腰硬联合麻醉下行下肢手术。术后随机分为观察组(P组)和对照组(M组),各50例,P组采用喷他佐辛90 mg+罗派卡因125 mg+0.9%生理盐水稀释到100 mL,M组采用吗啡8 mg+罗派卡因125 mg+0.9%生理盐水稀释到100 mL。分别于术后2、4、8、12、24、48 h随访情况,VAS疼痛评分、患者镇痛综合满意度、不良反应发生情况。结果两组患者手术后各时点VAS疼痛评分,患者镇痛综合满意度差异无显著性(P>0.05),不良反应P组恶心、呕吐2例,无皮肤瘙痒及呼吸抑制发生,总不良反应发生率为4%,M组不良反应恶心、呕吐11例,皮肤瘙痒8例,呼吸抑制2例,总不良反应发生率42%,组间比较差异有显著性(P<0.01)。结论喷他佐辛可安全用于老年人下肢骨科手术后硬膜外持续镇痛,镇痛效果与吗啡相当,不良反应发生率低于吗啡。

Clinical Observation of Pentazocine Combined with Ropivacaine in Epidural Analgesia of Lower Limb Orthopedic Surgery of Elderly Patients

Objective To analyze the effects of PCEA with combination of Pentazocine and Ropivacaine in senile lower limb orthopedic surgery. Methods 100 cases, age from 60 to 98, ASAⅠ~Ⅲ, with CSEA for lower limb orthopedic surgery with CSEA were selected and divided into observation group （group P） and control group （group M） randomly. The group P was treated with 90 mg Pentazocine, 125 mg Ropivacaine and 0.9% saline. While the group M was treated with 8 mg morphine, 125 mg Ropivacaine and 0.9% saline. And the follow-up observation was introduced after 2 h, 4 h, 8 h, 12 h, 24 h and 48 h, when VAS pain score, analgesia satisfaction, and adverse reaction were recorded.Results There was no signiifcant difference（P〉0.05）between group P and group M in VAS pain score and analgesia satisfaction. In group P, 2 cases were found nausea, and the Adverse Effects Rate was 4%. Whereas in group M, 11 cases were found nausea, 8 cases pruritus, 2 cases respiratory depression, and the adverse effects rate was 42%. The difference is signiifcant （P〈0.01）.Conclusion The application of Pentazocine in senile lower limb orthopedic surgery is safe. And the analgesia effect of Pentazocine is equal to that of morphine, when the Adverse effects Rate is lower than morphine.