摘要
目的比较等效剂量喷他佐辛与吗啡用于术后老年患者自控镇痛(PCIA)的效应及安全性。方法 40例ASAⅠ～Ⅱ级择期在全麻下行骨科手术的老年患者随机分为喷他佐辛组(P组,n=20)和吗啡组(M组,n=20),接受PCIA。镇痛药:P组为喷他佐辛120mg,M组为吗啡40mg;辅助用药均为格拉司琼3mg,并用生理盐水稀释至100mL。采取LCP模式给药:负荷量2.5mL+持续量1.5mL+单次按压注入量1mL,锁定时间15min。分别于术后4、8、16、24h记录VAS镇痛评分、Ramsay镇静评分及综合满意度评分,并记录24h镇痛药物用量及不良反应发生率。结果两组患者术后24h内各时点VAS、Ramsay评分及综合满意度评分差异无显著性(P>0.05);P组喷他佐辛用量为(51.55±1.91)mg,M组吗啡用量为(15.62±0.58)mg,组间比较差异有显著性(P<0.01);恶心、呕吐P组1例、M组5例,皮肤瘙痒M组6例。结论喷他佐辛可安全地用于老年患者术后静脉自控镇痛,其镇痛效应与等效剂量的吗啡相当,与吗啡用量比约为3.3∶1,不良反应发生率明显低于吗啡。
Objective To compare the analgesic efficacy and safety of pentazocine and morphine in equivalent dosage in patient - controlled intravenous analgesia （PCIA） in elderly patients. Methods Forty elderly patients （ ASA Ⅰ -Ⅱ ） scheduled for elective major orthopedic surgery under general anesthesia were enrolled and randomly assigned to receive 1.2mg/ml pentazocine （ group P, n = 20） and 0. 4 mg/ml morphine （ group M, n = 20） via PCIA. The procedure of PCA was as follows： loading dose set 2. 5 mL, continuous infusion set 1.5 mL/h and bolus set 1 mL with 15 minutes lock- out interval. The analgesic efficacy was assessed by visual analogue scale, Ramsay scale and Satisfaction scale. Total con- sumption of analgesics within the first 24 hours was recorded as well as the incidences of nausea, vomiting, pruritus and respiratory depression. Results VAS, Ramsay scale and satisfaction scale showed no significant difference between the two groups. The dosage of analgesic consumption within 24 hours was significantly higher in group P than that in group M （P 〈0. 01 ）. The incidence of adverse events was significantly lower in group P than that in group M （P 〈0. 01 ）. Conclusion Pentazocine can be safely administrated to elderly patients undergoing orthopedic surgery via PCIA with equal analgesic efficacy as morphine but fewer adverse reactions.
出处
《广东医学》
CAS
CSCD
北大核心
2010年第10期1228-1230,共3页
Guangdong Medical Journal
关键词
患者自控镇痛
老年
喷他佐辛
吗啡
patient-controlled analgesia
elderly
pentazocine
morphine
