奈福泮和吗啡用于老年人胸腔术后镇痛观察

目的　观察老年患者胸科术后静脉应用奈福泮和吗啡分别复合氟哌利多的镇痛效果。方法　选择90例ASAⅠ～Ⅱ级食管癌手术的老年患者 ,随机分为三组 ,奈福泮组 (N组 30例 )配方为奈福泮 110mg+氟哌利多 5mg +生理盐水共 10 0ml,负荷量给奈福泮 10mg ;吗啡组 (M组 30例 )配方为吗啡 4 0mg +氟哌利多 5mg +生理盐水共 10 0ml,负荷量给吗啡 2 5mg ;对照组 (C组 30例 )未行术后镇痛。患者手术结束后先给予负荷量 ,后接镇痛泵 (2ml/h) ,并于 4 8h内分别观察心率、血压、呼吸频率、动脉血氧饱和度 (SaO2 )、镇静评分 (SS)、视觉模拟评分 (VAS)以及恶心呕吐、瘙痒、排气时间延长等不良反应。结果　SS、VAS在N组与M组和C组差异有显著意义 ;呼吸频率和SaO2 在N组和M组与C组差异有显著意义。结论　奈福泮和吗啡分别复合氟哌利多应用于老年胸科术后镇痛 ,是一种有效的镇痛方法 ,奈福泮比吗啡更安全 ,不良反应更少。

Observation of nefopan and morphine given to the aged patient''''s thoracic postopertion analgesia

Objective To study the thorasic postoperation analgesia effects,side-effects of nefopan and morphine combined with droperidol given to the aged patients intravenously.Methods 90 patients,ASA Ⅰ～Ⅱ who had thoracic surgery were randomly divided into three groups:nefopan group(group N,30 cases,110mg nefopan and 5mg droperidol in 100ml of 0.9% saline,the load dosage was 10mg nefopan);Morphine group(group M,30 cases,40mg morphine and 5mg droperidol in 100ml of 0.9% saline,the load dosage was 2.5mg morphine);Control group(group C,30 cases,no postperative analgesia).The load dosage of analgesia were given at the end of operation,then AuBex analgesia pump(2ml/h) was carried out.The following data were recorded in postopration 48 hours:heart rate(HR),blood pressure(BP),respiration(RR),pulse oximeter(SaO 2),sedation score(SS),vision assess score(VAS),and the postoperation nansea,vomiting,prutitus,delayed exsufflation.Results Statistical differences were found in SS,VAS,RR and SaO 2 among three groups.Conclusion Nefopan and morphine combined with droperidol is a more effective postoperation analgesia to the aged patients,but nefopan is safer and less side-effects than morphine.