摘要
目的观察舒芬太尼术后静脉自控镇痛的镇痛效果及副作用发生率，以筛选出不同年龄的最佳剂量。方法选择择期胃肠道、腹部大手术患者60例，ASAⅠ～Ⅱ级，术前检查无心、肺、肝、肾功能明显异常者。随机分为两组，每组30例，A组（成年组）年龄30～59岁，其中男17例，女13例；B组（老年组）年龄60～75岁，其中男14例，女16例。每组按术后镇痛用药剂量不同随机分为Ⅰ、Ⅱ两个亚组，每亚组15例。给予AⅠ亚组1．5μg/kg，AⅡ亚组2．0μg/kg，BⅠ亚组1．0μg／kg，BⅡ亚组1．5μg／kg剂量的舒芬太尼。PCIA持续剂量2ml／h，PCA0．5ml，锁定时间15min,术后2、4、8、16、24h和48h双盲对照观察各组视觉模拟评分（VAS）、Ramsay评分、满意度评分及恶心呕吐等不良反应发生情况。结果成年组AⅡ亚组（2．0μg／kg）镇痛效果明显优于AⅠ亚组（1．5μg/kg）（P〈0．05），镇静效果无差异（P〉0．05）；而老年组两亚组之间镇痛效果无差异（P〉0．05），镇静效果有差异（P〈0．05）。结论随着年龄的增加，同等剂量舒芬太尼对老年人产生的镇痛作用较年轻人强，且作用时间延长；不同年龄组病人舒芬太尼术后静脉自控镇痛呈不同的量效关系。
Objective To investigate the effect of analgesia and side-effect of sufentanyl in PCIA and select the optimal dosage in patients of different ages. Methods Patients tmderwent gastrointestinal and abdominal surgeries were divided into two groups according to age. Group A （30～59y）, Group B （60～75y）,each group was divided into two sub-groups （ Ⅰ and Ⅱ ） according to the different dosages of sufentanyl. AⅠ group received sufentanyl 1.5μg/kg, AⅡ group 2.0μg/kg, BⅠ 1.0μg/kg, BⅡ 1.5μg/kg. PCIA included bolus of 0.5 ml with lock time 15min and backgrotmd 2ml/h, and the outcomes were evaluated by visual analgesia scales, Ramsay scales and patient satisfied scales. Side effects such as nausea and vomiting were also recorded. Results The effect of analgesia of adult A Ⅱ （2.0μg/kg） was obviously better than that of A Ⅰ （1.5μg/kg） （P 〈 0.05 ）, while there were no difference between the group B Ⅰ and B Ⅱ （ P 〉 0.05）. Conclusion With the increase of the age, the same dosage of sufentanyl can produce different effect of analgesia in adult and the elder. There is different relationship of dosage and effect of sufentanyl in PCIA in patients of different ages.
出处
《哈尔滨医科大学学报》
CAS
北大核心
2006年第5期409-411,共3页
Journal of Harbin Medical University
关键词
舒芬太尼
术后镇痛
镇静
年龄
sufentanyl
postoperative analgesia
sedation
age
