丁丙诺啡透皮贴剂对老年股骨转子间骨折术后的镇痛效果与安全性

Analgesic effect and safety of buprenorphine transdermal patch in the elderly after intertrochanteric fracture surgery

目的观察老年股骨转子间骨折术后使用丁丙诺啡透皮贴剂止痛临床效果。方法将67例老年股骨转子间骨折术后患者分为试验组34例和对照组33例。试验组术后予以丁丙诺啡透皮贴剂,对照组术后予以同等包装不含丁丙诺啡药用成分的空白贴剂。术后第1,2,3,4,5,6,7天,记录2组患者收缩压、舒张压、心率、视觉模拟评分(VAS),同时统计药物不良反应。结果治疗后第2,3,4,5天,试验组的VAS分别为(6.69±1.83),(4.22±1.56),(3.73±2.20),(3.13±1.58);对照组的VAS分别为(8.15±1.36),(7.75±2.26),(7.14±1.67),(6.82±2.24),组间比较差异有统计学意义(P<0.05)。试验组的药物不良反应主要有恶心呕吐、皮疹,对照组的药物不良反应主要有恶心呕吐,2组药物不良反应发生率分别为23.53%和6.06%,差异有统计学意义(P<0.05)。结论研究表明丁丙诺啡透皮贴剂对老年股骨转子间骨折术后有更好的镇痛效果,但术后2日内注意药物不良反应的发生。

Objective To observe the analgesic effect of buprenorphine transdermal patches in patients after intertrochanteric fracture surgery.Methods Sixty- seven patients with intertrochanteric fracture surgery were randomly divided into control group（ n = 33） and treatment group（ n = 34）. Patients in control group were given placebo patches after operation. Patients in treatment group were given buprenorphine transdermal patches. Systolic blood pressure（ SBP）,Diastolic blood pressure（ DBP）,heart rate（ HR）,visual nalogue score（ VAS） and the incidence of adverse drug reactions of the two groups were observed on 1,2,3,4,5,6,7 d after surgery. Results On 2,3,4,5 d after treatment,VAS score were 6. 69 ± 1. 83,4. 22 ± 1. 56,3. 73 ± 2. 20,3. 13 ± 1. 58,respectively in treatment group. VAS score were 8. 15 ± 1. 36,7. 75 ± 2. 26,7. 14 ± 1. 67,6. 82 ± 2. 24 respectively in control group.They were significantly lower than those in control group（ P〈0. 05）. The incidences of adverse drug reactions with nausea and vomiting were20. 59%（ 7 /34 cases） in treatment group and 6. 06%（ 2 /33 cases） in control group respectively.The incidence of adverse drug reactions with rashes was 2. 94%（ 1 /34 cases） in treatment group. Postoperative incidence of adverse drug reactions with nausea and vomiting in treatmentgroup was significantly higher than that in control group（ P〈0. 05）. The incidence of adverse drug reaction with rashes in treatment group had no significant difference with that in control group（ P〉0. 05）. Conclusion The results indicated that buprenorphine transdermal patches had better analgesia for the elderly after intertrochanteric fracture surgery,while the adverse drug reaction should be monitored within 2 day after surgery.