目的 观察右旋美托咪定复合舒芬太尼静脉自控镇痛对骨科患者术后谵妄发生率的影响。方法 拟行择期骨科手术患者400例，年龄≥60岁，随机分为右旋美托咪定复合舒芬太尼组(DS组)和舒芬太尼组(S组)，术后连续2d行PCIA，并随访谵妄的发生(CAM—ICU法)、视觉模拟评分（VAS评分）和舒芬太尼使用量。结果 DS组术后谵妄发生率明显低于S组(8％VS．31％)(P<0．05)。DS组术后VAS评分及舒芬太尼用量均明显低于s组(P<0.05)。结论 与单纯应用舒芬太尼相比，右旋美托咪定复合舒芬太尼静脉自控镇痛能够减少骨科患者术后谵妄的发生率。
Objective To investigate the efficacy of dexmedetomidine combined with sufentanil analgesia on prevent postoperative delirium in orthopedic patients．Methods Four hundreds patients who were aged 60 years or older and underwent elective orthopedic surgery were randomized into dexmedetomidine plus sufentanil group(group DS)or sufentanil group(group S)．After surgery，patients were given 2 days PCIA according two groups．The presence of delirium，the visual analog scale(VAS)and the consumptions of sufentanil were recordeel．Results The incidence of delirium was significantly lower in the group DS than that in the group S(8％versus 31％)(P<0．05)．The point prevalence of delirium in the group DS was also lower compared with group S. The VAS scores were significantly low，the SUfentanil consumptions were remarkably less in group DSthan in group s．Conclusion Compare sufentanil group，group DS postoperative analgesia significantly reduce the incidence and the prevalence of delirium in orthopedic patients．
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