摘要
目的 :评价老年病人术后自控静脉镇痛 (PCIA)的临床疗效及安全性。方法 :随机选择手术后病人 (脑外手术除外 )90 0例 ,按年龄分成两组。老年组 :6 0 0例 ,年龄 6 5～ 90岁 ,ASAⅡ -Ⅳ级 ;对照组 (青、中年组 ) :30 0例 ,年龄 18～ 6 3岁 ,ASAⅠ～Ⅲ级。两组均采用药物配方相同的自控静脉镇痛。配方为 :曲马多 6 0 0mg +芬太尼 0 .3mg +氟哌啶 5mg +0 .9%生理盐水共计 6 0ml;PCA参数设置为 :负荷剂量 3～ 5ml,单次PCA量 0 .5～ 1ml,锁定时间 10～ 15min ,背景流量 0 .7～ 1ml/h。观察镇痛效果、镇静程度、舒适评分、不良反应 ;监测RR、MAP、HR、SpO2 及镇痛用药总量。结果 :两组的镇痛效果、镇静程度、舒适评分无显著差异 ;但老年组用药量较少 ,两组不良反应的发生率均低 ,且无显著性差异 ;呼吸和循环平稳。结论 :老年病人术后PCIA镇痛效果好 ,副作用少 ,可以安全使用 ,但应注意用药剂量 ,加强生命体征监测 ,以策安全。
Objective:To evaluate the effectiveness and safety of patient-controlled intravenous analgesia (PCIA) for elderly patients.Methods:900 patients after operation (except for cerebral operation) were allocated to the aged group ( n =600,aged 65～90 years,ASAⅡ-Ⅳ) or the control group (young or middle-age group, n =300,aged 18～63 years,ASAⅠ-Ⅲ) and received PCIA.The PCIA solution consist of tramadol 600 mg,fentanyl 0.3 mg,droperidol 5 mg and NS 40 ml.Loading dose 3～5 ml,background infusion 0.7～1 ml/h,bolus 0.5ml,lockout time 10～15 min.The intensity of pain,level of sedation,scale of comfort and side effects were assessed.Meanwhile,RR,MAP,HR,SpO 2 were monitored and the total dosage of analgesic were recorded also.Results:There was no significant difference in VAS (Visual analogue scale),RSS(Ramesay sedation),and BCS (Bruggrmann comfort scale) in both groups.But,the consumption of the aged group was significantly fewer.The incidence of the adverse effects was lower in both groups and there was no significant difference between groups.The respiration and circulation was smooth in both groups throughout analgesia period.Conclusion:The efficacy of patient-controlled intravenous analgesia (PCIA) in elderly patients is good.The incidence of adverse effects is low.With adequate dosage and monitoring PCIA can be used safely for elderly postoperative analgesia.
出处
《重庆医科大学学报》
CAS
CSCD
2003年第5期598-600,共3页
Journal of Chongqing Medical University
关键词
老年人
镇痛
病人控制
静脉内
The elderly
Analgesia
Patient-controlled
Intravenous
