舒芬太尼在老年患者术后皮下镇痛的临床观察(1)
[摘要] 目的 探讨舒芬太尼在老年患者术后皮下镇痛的临床效果。 方法 按照随机数字表法将2012年9月～2015年8月我院收治的80例择期行下肢手术或下腹部手术的患者均分为实验组和对照组，实验组采取皮下自控镇痛，对照组采取静脉自控镇痛。观察两组患者镇痛评分、镇静评分、PCA次数、不良反应发生情况和总体满意度。结果 术后4 h、12 h、24 h、48 h，两组患者镇痛评分比较，差异无统计学意义(P>0.05)；术后4 h、12 h、24 h、48 h，两组患者镇静评分比较，差异无统计学意义(P>0.05)；术后4 h、12 h、24 h、48 h，两组患者自控镇痛(Patient Controlled Analgesia，PCA)次数比较，差异无统计学意义(P>0.05)；实验组患者恶心、呕吐、寒战、皮肤瘙痒、尿潴留发生率低于对照组，差异有统计学意义(P<0.05)。两组患者呼吸抑制发生率比较，差异无统计学意义(P>0.05)。两组患者总体满意情况比较，差异无统计学意义(P>0.05)。 结论 舒芬太尼在老年患者术后镇痛中效果良好，采取皮下自控镇痛和静脉自控镇痛效果相似，但皮下自控镇痛操作更加简单，临床应用价值较高。
[关键词] 舒芬太尼；老年患者；术后；皮下镇痛；效果
[中图分类号] R722.1 [文献标识码] B [文章编号] 1673-9701(2016)11-0116-03
[Abstract] Objective To discuss the postoperative subcutaneous analgesic effect of sufentanil in elderly patients. Methods 80 elderly patients who were given operation in lower limbs or lower abdomen from September 2012 to August 2015 were randomly selected and divided into study group and control group. Patients in the study group were given patient controlled subcutaneous analgesia(PCSA)， while patients in the control group were given patient-controlled intravenous analgesia (PCIA). The analgesia scores， sedation scores， times of patient controlled analgesia (PCA)， incidence of adverse events， and overall satisfaction of the two groups were observed. Results There was no significant difference in analgesia scores between two groups at 4 h， 12 h， 24 h， and 48 h after operation(P>0.05). There was no significant difference in sedation scores and times of PCA between two groups at 4 h， 12 h， 24 h， and 48 h after operation(P>0.05). The incidence rates of nausea， vomiting， chill， pruritus，and urinary retention were significantly lower in the study group than in the control group(P<0.05). There was no significant difference in incidence of respiratory depression between two groups(P>0.05). There was no significant difference in overall satisfaction of patients between two groups (P>0.05). Conclusion The postoperative subcutaneous analgesic effect of sufentanil is favorable in elderly patients. Though the effects of PCSA and PCIA are similar， the management of PCSA is more simple， thus it has higher value in clinical application.
[Key words] Sufentanil； Elderly patient； Postoperative； Subcutaneous analgesia； Effect
舒芬太尼是芬太尼的衍生物，有较高的选择性，在镇痛方面应用广泛[1]。临床研究指出，舒芬太尼常发生呼吸抑制等不良反应，导致麻醉或镇痛效果受限[2]。因此优化舒芬太尼麻醉用药方案、降低不良反应是麻醉医师普遍关注的研究方向。本研究主要分析舒芬太尼皮下给药在老年患者术后皮下镇痛中的作用效果，以期为舒芬太尼临床应用提供参考，现报道如下。
1 资料与方法
1.1 一般资料
选取2012年9月～2015年8月我院收治的80例择期行下肢手术或下腹部手术的患者作为研究对象。按照随机数字表法将患者分为实验组和对照组各40例，实验组男22例，女18例，年龄65～84岁，平均(70.9±8.3)岁；体重48～80 kg，平均(55.12±4.77)kg。对照组男23例，女17例，年龄65～83岁，平均(71.2±7.6)岁；体重48～80 kg，平均(56.10±4.85)kg。两组患者的临床资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(蔡爱球 李锐 邓伟)
[关键词] 舒芬太尼；老年患者；术后；皮下镇痛；效果
[中图分类号] R722.1 [文献标识码] B [文章编号] 1673-9701(2016)11-0116-03
[Abstract] Objective To discuss the postoperative subcutaneous analgesic effect of sufentanil in elderly patients. Methods 80 elderly patients who were given operation in lower limbs or lower abdomen from September 2012 to August 2015 were randomly selected and divided into study group and control group. Patients in the study group were given patient controlled subcutaneous analgesia(PCSA)， while patients in the control group were given patient-controlled intravenous analgesia (PCIA). The analgesia scores， sedation scores， times of patient controlled analgesia (PCA)， incidence of adverse events， and overall satisfaction of the two groups were observed. Results There was no significant difference in analgesia scores between two groups at 4 h， 12 h， 24 h， and 48 h after operation(P>0.05). There was no significant difference in sedation scores and times of PCA between two groups at 4 h， 12 h， 24 h， and 48 h after operation(P>0.05). The incidence rates of nausea， vomiting， chill， pruritus，and urinary retention were significantly lower in the study group than in the control group(P<0.05). There was no significant difference in incidence of respiratory depression between two groups(P>0.05). There was no significant difference in overall satisfaction of patients between two groups (P>0.05). Conclusion The postoperative subcutaneous analgesic effect of sufentanil is favorable in elderly patients. Though the effects of PCSA and PCIA are similar， the management of PCSA is more simple， thus it has higher value in clinical application.
[Key words] Sufentanil； Elderly patient； Postoperative； Subcutaneous analgesia； Effect
舒芬太尼是芬太尼的衍生物，有较高的选择性，在镇痛方面应用广泛[1]。临床研究指出，舒芬太尼常发生呼吸抑制等不良反应，导致麻醉或镇痛效果受限[2]。因此优化舒芬太尼麻醉用药方案、降低不良反应是麻醉医师普遍关注的研究方向。本研究主要分析舒芬太尼皮下给药在老年患者术后皮下镇痛中的作用效果，以期为舒芬太尼临床应用提供参考，现报道如下。
1 资料与方法
1.1 一般资料
选取2012年9月～2015年8月我院收治的80例择期行下肢手术或下腹部手术的患者作为研究对象。按照随机数字表法将患者分为实验组和对照组各40例，实验组男22例，女18例，年龄65～84岁，平均(70.9±8.3)岁；体重48～80 kg，平均(55.12±4.77)kg。对照组男23例，女17例，年龄65～83岁，平均(71.2±7.6)岁；体重48～80 kg，平均(56.10±4.85)kg。两组患者的临床资料比较，差异无统计学意义(P>0.05)，具有可比性。, http://www.100md.com(蔡爱球 李锐 邓伟)