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多模式镇痛在老年髋部骨折患者中的应用 被引量:8

Application of multimodal pain management in elderly patients with hip fracture surgery
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摘要 目的探讨多模式镇痛对老年髋部骨折患者术后镇痛及早期康复中的作用。方法将96例拟行髋部骨折手术的老年患者按随机数字表法分为多模式镇痛组(46例)和传统模式镇痛组(50例)。传统模式镇痛组采用持续硬膜外麻醉,术毕安装硬膜外镇痛泵;多模式镇痛组在此基础上,术前2天常规服用洛索洛芬钠片,并于术中进行切口逐层浸润麻醉。观察术后1~7天两组患者的疼痛模拟视觉评分,并记录患者首次直腿抬高时间、活动步数、术后恶心、呕吐等不良反应。结果多模式镇痛组术后1~3天VAS评分均低于传统模式镇痛组,且术后早期功能恢复情况优于传统模式组。两组术后不良反应的发生率差异无统计学意义。结论多模式镇痛对老年髋部骨折患者术后具有较好的镇痛效果,且利于患者术后早期功能恢复。 Objective To determine the role of multimodal pain management in postoperative analgesia and early rehabilitation in elderly patients undergoing hip fracture surgery.Methods Ninety six elderly patients with hip fractures were randomly divided into two groups:multimodal analgesia group(n = 46) and traditional analgesia group(n = 50).The patients in the multimodal analgesia group were given Loxoprofen 60 mg bid,2 days preoperative.Intraoperative periarticular infiltrated anesthesia and continuous postoperative epidural infusion of ropivacaine were applied in this group.The traditional analgesia group was only given continuous postoperative epidural infusion of ropivacaine.VAS scores,postoperative side effects and walk ability were recorded.Results The VAS scores were lower in the multimodal analgesia group than that in the traditional analgesia group on day 1 to day 3 after surgery.The multimodal analgesia group had superior walking ability at early stage.No significant differences were found with respect to the side effects between the two groups.Conclusion The multimodal perioperative pain management provides a superior pain relief and is good for functional rehabilitation at early stage.
作者 庞波 张慧伟
出处 《实用医院临床杂志》 2014年第4期167-169,共3页 Practical Journal of Clinical Medicine
关键词 髋部骨折 镇痛 术后 老年 Hip fracture Analgesia Post-operation Elderly
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  • 1Feldt KS, Oh HL. Pain and hip fracture outcomes for older adults [J]. Orthop Nuts,2000,19(6) :35-44.
  • 2Morrison RS, Magaziner J, Gilbert M, et al. Relationship between pain and opioid analgesics on the development of delirium following hip fracture[J].J Gerontol A Biol Sci Med Sci,2003,58 (1):76- 81.
  • 3Morrison RS, Magaziner J, McLaughlin MA, et al. The impact of post- operative pain on outcomes following hip fracture[J].Pain, 2003, 103(3) :303-311.
  • 4Morrison RS, Siu AL. A comparison of pain and its treatment in ad- vanced dementia and cognitively intact patients with hip fracture [J]. Pain Symptom Manage,2000,19(4) :240-248.
  • 5Viscusi ER, Parvizi J, Tarity TD. Developments in spinal and epi- dural anesthesia and nerve blocks for total joint arthroplasty:what is new and exciting in pain management[ J]. lnstr Course Lect,2007, 56 :139-145.
  • 6康鹏德,王浩洋,沈彬,杨静,周宗科,裴福兴,马俊,黄强.加入局部浸润镇痛的多模式镇痛在全膝关节置换中的应用[J].中华骨科杂志,2013,33(3):246-251. 被引量:47
  • 7Fu PL,Xiao J, Zhu YL, et al. Efficacy of a multimodal analgesia pro- tocol in total knee arthroplasty : a randomized, controlled trial [J]. Int Med Res ,2010,38 (4) : 1404-1412.
  • 8徐建国,吴新民,罗爱伦,等.成人手术后疼痛处理专家共识.中华医学会麻醉学分会,2009.
  • 9张世民,李海丰,俞光荣.老年髋部骨折的临床治疗流程[J].中国矫形外科杂志,2005,13(18):1365-1368. 被引量:61
  • 10Busch CA, Whitehouse MR, Shore B J, et al. The efficacy of periar- ticular multimodal drug infiltration in total hip arthroplasty[ J ]. Clin Orthop Relat Res ,2010,468 ( 8 ) :2152-2159.

二级参考文献79

  • 1刘兴会,吴连方.分娩镇痛的临床应用与管理[J].中华妇产科杂志,2005,40(6):362-364. 被引量:90
  • 2黄宇光.新型长效局麻药在麻醉与神经阻滞中的研究进展[J].广东医学,2006,27(11):1602-1603. 被引量:10
  • 3Morris AH, Zuckerman JD. National consensus conference on improving the continuum of care for patients with hip fracture [ J ]. J Bone Joint Surg Am. 2002,84A(4): 670 -674.
  • 4Zuckennan JD, Sakales SR, Fabian DR, et al. The challenge of geriatric hip fractures [ J ]. Bull N Y Acad Med, 1990,66 ( 3 ): 255 - 265.
  • 5Zuckerman JD, Sakales SR, Fabian DR, et al. Hip fractures in geriatric patients: Results of an interdisciplinary hospital care program [J]. Clin Orthop,1992, (274): 213 -225.
  • 6Koval KJ,Zuckerman JD. Hip Fractures: Ⅰ. Overview and evaluation and treatment of femoral - neck fractures [ J ]. J Am Acad Orthop Surg. 1994,2(3): 141 -149.
  • 7Koval KJ,Zuckerman JD. Hip Fractures: Ⅱ. Evaluation and treatment of intertrochanteric fractures [ J ]. J Am Acad Orthop Surg.1994,2(3): 150 - 156.
  • 8Koval KJ, Zuckerman JD. Functional recovery after fracture of the hip [J]. J Bone Joint Surg Am. 1994,76(5): 751 -758.
  • 9Zuckerman JD. Hip fracture[J]. N Engl J Med. 1996,334(23):1519 - 1525.
  • 10Koval KJ,Aharonoff GB,Su ET, et al. Effect of acute inpatient rehabilitation on outcome after fracture of the femoral neck or intertrochanteric fracture[ J]. J Bone Joint Surg, 1998,80A(3 ) :357 - 364.

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