蔡爱球　李　锐　邓　伟江西省吉安市中心人民医院麻醉科，江西吉安　343000

舒芬太尼在老年患者术后皮下镇痛的临床观察

蔡爱球李锐邓伟
江西省吉安市中心人民医院麻醉科，江西吉安343000

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 Contro11ed Ana1gesia，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。

舒芬太尼；老年患者；术后；皮下镇痛；效果

［Abstract］Objective To discuss the postoperative subcutaneous ana1gesic effect of sufentani1 in e1der1y patients. Methods 80 e1der1y patients who were given operation in 1ower 1imbs or 1ower abdomen from September 2012 to Au gust 2015 were random1y se1ected and divided into study group and contro1 group.Patients in the study group were given patient contro11ed subcutaneous ana1gesia（PCSA），whi1e patients in the contro1 group were given patient-contro11ed intravenous ana1gesia（PCIA）.The ana1gesia scores，sedation scores，times of patient contro11ed ana1gesia（PCA），incidence of adverse events，and overa11 satisfaction of the two groups were observed.Results There was no significant difference in ana1gesia 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，chi11，pruritus，and urinary retention were significant1y 1ower in the study group than in the contro1 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 overa11 satisfaction of patients between two groups（P＞0.05）. Conclusion The postoperative subcutaneous ana1gesic effect of sufentani1 is favorab1e in e1der1y patients.Though the effects of PCSA and PCIA are simi1ar，the management of PCSA is more simp1e，thus it has higher va1ue in c1inica1 app1ication.

［Key words］Sufentani1；E1der1y patient；Postoperative；Subcutaneous ana1gesia；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。……