目的:观察帕瑞昔布钠或地佐辛辅助舒芬对老年胸腔镜术后镇痛效果。方法:胸腔镜肺叶切除术的
老年病人54 例，随机分为帕瑞昔布钠组( P 组) 、地佐辛组( D) 、舒芬太尼组( S 组) ，每组18 例。手术切皮前
20minP 组静注帕瑞昔布钠40mg，D 组地佐辛10mg，S 组给予2mL 生理盐水。缝皮时停止麻醉药，连接舒芬静脉
自控镇痛泵，记录术后1h 镇静评分及术后1、4、8、12、24、48hVAS 评分，记录术后48h 所需舒芬的量及不良反应。
结果:术后1h 镇静评分P 组、D 组高于S 组( P＜0． 05) ，术后VAS 评分1、4、8、12h P 组、D 组低于S 组( P＜0． 05) ，
24、48h 三组无统计学意义，P 与D 组各时点无差异;舒芬量P 组、D 组低于S 组( P＜0． 05) ，三组不良反应无明显
差异。结论:帕瑞昔布钠或地佐辛辅助舒芬静脉自控镇痛对老年胸腔镜术后早期疼痛都有良好的抑制作用。

Objective: To sdudy the aid effects of Parecoxib sodium or Dezocine to Sufentanil on
the postoperative analgesia in old patient with thoracoscope． Methods: 54 old cases of thoracoscope pulmonary
lobectomy were divided into three groups，Parecoxib sodium group( P) 、Dezocine goupr( D) 、
Sufentanil goupr( S) ( n = 18) ． Parecoxib sodium 40mg in P group 、Dezocine 10 mg， in D group and
2ml NS in S group were injected intravenously 20min before incide． The anesthesia was stoped at the
time point of suture， simulteneously the intravenous PCA pump of Sufentanil was used． The sedative
score was recorded 1hr after operation and VAS were recorded 1、4、8、12、24、48h after operation． The
doses of Sufentanil and adverse effect were recorded． Results: The sedative score of P and D groups
were higher than S group after operation． The VAS of P and D groups lower than S group at the time
point of 1、4、8、12h after operation( P＜0． 05) ． There were no significant different between P and D
group about VAS at all time point after operation，and among three groups 24h and 48h after operation．
The Sufentanil dosage of P and D group were lower than S group( P＜0． 05) ， there were no significant
different among the three groups about adverse effect． Conclusion: There were significant analgesia
effects of Parecoxib sodium and Dezocine aiding to Sufentanil in old patient thoracoscope during early

R614． 2

 收稿日期: 2013－04－15; 修回日期: 2013－06－17
基金项目: 内蒙古自治区卫生厅项目( 2011126)
作者简介: 解雅英( 1969－) ，女，内蒙古医科大学附属医院麻醉科主任医师。
通讯作者: 于建设，教授，硕士研究生导师，E－mail: xyy7156@ qq． com 内蒙古医科大学附属医院麻醉科， 010050