纳布啡联合舒芬太尼在老年全髋关节置换术后静脉自控镇痛中的应用

The application of nalbuphine combined with sufentanil in patient-controlled intravenous analgesia after total hip arthroplasty in the elders

目的探讨纳布啡联合舒芬太尼在老年全髋关节置换术后静脉自控镇痛(PCIA)中的应用效果。方法选取2015年4月至2017年2月许昌市中心医院收治的90例行全髋关节置换术的老年患者作为研究对象,按随机数表法分为Ⅰ组、Ⅱ组、Ⅲ组,每组30例。Ⅰ组接受纳布啡麻醉,Ⅱ组接受舒芬太尼麻醉,Ⅲ组接受纳布啡+舒芬太尼麻醉。观察3组患者疼痛视觉模拟评分(VAS评分)、Ramsay镇静评分、镇痛满意度及术后不良反应发生情况。结果术后1、4、12、24 h,Ⅱ、Ⅲ组VAS评分均低于Ⅰ组,差异有统计学意义(P均<0.05);术后1、4、12 h,Ⅰ、Ⅲ组Ramsay评分均高于Ⅱ组,差异有统计学意义(P均<0.05);Ⅲ组镇痛满意度均高于Ⅰ、Ⅱ组,差异有统计学意义(P均<0.05);Ⅲ组不良反应发生率均低于Ⅰ、Ⅱ组,差异有统计学意义(P均<0.05)。结论纳布啡联合舒芬太尼应用于老年全髋关节置换术后PCIA中效果显著,可提高镇痛、镇静效果及镇痛满意度,安全性高,具有较高的临床价值。

Objective To investigate the effect and safety of applying nalbuphine combined with sufentanil in patient-controlled intravenous analgesia after total hip arthroplasty in the elders.Methods Ninety cases elderly patients with total hip arthroplasty in Xuchang Central Hospital from April of 2015 to February of 2017 were treated as subjects.According to the random indicator method divided them into groupⅠ,groupⅡ,groupⅢ,30 cases in each group.GroupⅠwas administrated with nalbuphine,groupⅡwas administrated with sufentanil and groupⅢwas administrated with the combination of nalbuphine and sufentanil.The visual analogue scale(VAS)pain scores,ramsay sedation scores,analgesia satisfaction as well as adverse reactions of the three groups were evaluated.Results One,four,twelve and twenty four hours after operation,the VAS scores of groupⅡand groupⅢwere evidently lower than that of groupⅠwith a statistical difference(P<0.05).One,four and twelve hours after operation,the ramsay sedation scores of groupⅠand groupⅢwere significantly higher than that of groupⅡwith a big difference(P<0.05).Analgesia satisfaction groupⅢwas higher than groupⅠand groupⅡ,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in groupⅢwere lower than those in groupⅠand groupⅡ,and the differences were statistically significant(P<0.05).Conclusion The application of nalbuphine and sufentanil in patient-controlled intravenous analgesia after otal hip arthroplasty in old patients proves to be effective and safe and of high clinical value as well.