舒芬太尼辅助吗啡对老年冠心病患者胸腔镜肿瘤术后镇痛的效果

目的：观察舒芬太尼辅助吗啡用于老年冠心病患者胸腔镜肿瘤术后镇痛的效果和安全性。方法选择行胸腔镜肿瘤手术的老年冠心病患者51例，随机分为吗啡组（ M组）、舒芬太尼组（ S组）、舒芬太尼辅助吗啡组（ MS组），每组17例。 M组：吗啡1．5 mg／kg及托烷司琼2 mg加注射用生理盐水至100 ml；S组：舒芬太尼1．5μg／kg及托烷司琼2 mg加注射用生理盐水至100 ml；MS组：吗啡0．5 mg／kg，舒芬太尼0．75μg／kg及托烷司琼2 mg加注射用生理盐水至100 ml。观察术后3组2、4、8、12、24、48 h的视觉模拟评分（ VAS）、Ramsay镇静评分及不良反应情况。结果3组术后镇痛效果均较满意，但MS组VAS评分及Ramsay镇静评分均优于M组和S组，且不良反应少。结论舒芬太尼辅助吗啡用于老年冠心病患者胸腔镜肿瘤术后镇痛，效果好，且不良反应少，是1种安全有效的镇痛方法。

The Effect of Morphine and Sufentanil on Analgesia of Elderly Patients with Coronary Heart Disease after Thoracoscopic Tumor Surgery

Objective To observe the effect and safety of sufentanil and morphine for old patients with coronary heart on the postperative analgesia after thoracoscope cancer surgery.Methods 51 cases of elderly patients with thoracoscope cancer with coronary heart disease were randomly divided into morphine group ( M) ,sufentanil group ( S group) ,sufentanil assisted morphine group (MS),and 17 cases in each.Group M:morphine 1.5 mg/kg and tropisetron 2 mg and physiological saline to 100 ml;Group S:sufentanil 1.5 μg/kg and tropisetron 2 mg and physiological saline to 100 ml;Group MS:morphine 0.5 mg/kg,sufentanil 0.75μg/kg and tropisetron 2 mg and physiological saline to 100 ml.Visual analog scale( VAS) ,Ramsay sedation score and adverse re-actions were recorded at 2,4,8,12,24,48 h after the operation.Results The postoperative analgesia of the 3 groups were all sat-isfactory,but MS group VAS scores and Ramsay sedation score were better than M group and S group,and fewer adverse reac-tions.Conclusion Sufentanil assist morphine for elderly patients with coronary heart on the postoperative analgesia after thoraco-scope cancer surgery can provide good postoperative analgesia and fewer adverse reactions,and it is a safe and effective analgesia method.