比较丁丙诺啡透皮贴剂和氟比洛芬酯注射液在冻结肩患者手法松解术及康复训练中的近期镇痛效果

Comparison of short-term analgesic effects of transdermal buprenorphine patch and flurbiprofen axetil injection for patients with frozen shoulder during loosening therapy and rehabilitation exercise

目的比较丁丙诺啡透皮贴剂和氟比洛芬酯注射液在冻结肩患者手法松解术与康复训练中的近期镇痛效果。方法收集2013年10月至2018年2月广州医科大学附属第二医院收住院的冻结肩患者40例,年龄38~79岁,性别不限,按照随机数字表法分为丁丙诺啡贴剂组(BP组)与氟比洛芬酯组(F组),每组20例。所有患者在进行肩关节手法松解时,均接受单次臂丛神经阻滞联合异丙酚静脉麻醉。BP组在术前48h至术后10d,均使用丁丙诺啡透皮贴剂镇痛。F组静脉推注氟比洛芬酯镇痛。采用视觉模拟评分(VAS)评估手法松解当日与术后7、10d康复运动时的镇痛效果,并评价治疗冻结肩的疗效。结果BP组患者术后7、10d时VAS评分均低于F组[(1.7±0.9)比(4.1±0.8),(1.2±0.9)比(2.9±1.1),P<0.05]。术后7、10d时VAS0~3的患者例数,BP组多于F组(19比4,20比13,P<0.05)。两组冻结肩患者手法松解疗效的比较差异无统计学意义(P>0.05)。结论在冻结肩患者的手法松解和随后的康复运动中,丁丙诺啡透皮贴剂的镇痛效果优于氟比洛芬酯药物镇痛。

Objective To compare the short-term analgesic effects of transdermal buprenorphine and flurbiprofen axetil injection in patients with frozen shoulder during loosening therapy and rehabilitation exercise. Methods From October 2013 to February 2018, a total of 40 patients with frozen shoulder of both sexes, aged 38-79 years, were enrolled in the study in the Second Affiliated Hospital of Guangzhou Medical University. The patients were assigned randomly into two groups based on the random number table, buprenorphine patch group (group BP) and flurbiprofen group (group F), 20 cases in each group. All patients received brachial plexus block and propofol anesthesia during the loosening therapy. Patients received transdermal buprenorphine in group BP, and flurbiprofen axetil injection in group F. VAS was observed at the day after the therapy and 7, 10 d during rehabilitation exercise. The therapeutic effects were also assessed. Results VAS was lower in group BP than that in group F at the day after the therapy and 7, 10 d during rehabilitation exercise respectively[(1.7±0.9) vs.(4.1±0.8),(1.2±0.9) vs.(2.9±1.1), P<0.05]. The number of patients with VAS 0-3 at 7, 10 days after the therapy was more in group BP than that in group F (19 vs. 4, 20 vs. 13, P<0.05). There was no statistical significance in the therapeutic effects between the two groups (P>0.05). Conclusion The analgesic effects of buprenorphine transdermal patch is better than that of flurbiprofen for patients with frozen shoulder during loosing therapy and subsequent rehabilitation exercise.