舒芬太尼联合布托啡诺用于下肢骨折手术术后镇痛的效果探讨

Effect of Sufentanil Combined with Butorphanol on Analgesia after Lower Limb Fracture Surgery

目的观察下肢骨折手术术后应用舒芬太尼联合布托啡诺镇痛的临床效果及安全性。方法便利选取2017年5月—2018年5月该院收治的下肢骨折患者96例为研究对象,采用随机分组的方式,将其分为A组(舒芬太尼联合布托啡诺)、B组(布托啡诺)和C组(舒芬太尼),每组32例,术后分别给予持续静脉镇痛,观察3组患者的术后6、12、24、48 h的视觉模拟评分(VAS)、Ramsay评分及不良反应发生情况。结果B组在术后6 h、12 h、24 h几个时间点的VAS评分基本满意。24 h内,A组和C组的镇痛效果优于B组,术后48 h时,3组患者的VAS评分良好,差异无统计学意义(P>0.05);不良反应显示,A组总发生率15.62%;B组总发生率31.25%;C组总发生率37.5%;A组与B、C组相比,不良反应发生率更低,差异有统计学意义(χ^2=5.248,P=0.005)。结论舒芬太尼联合布托啡诺用于下肢骨折手术术后镇痛的效果显著优于单独使用布托啡诺或者舒芬太尼,联合应用的镇痛效果更加明显,且不良反应更少,安全性更高。

Objective To observe the clinical efficacy and safety of sufentanil combined with butorphanol analgesia after surgery for lower extremity fractures.Methods Convenient selected ninety-six patients with lower extremity fractures admitted to our hospital from May 2017 to May 2018 were enrolled in the study.They were randomly divided into group A(sufentanil combined with butorphanol)and group B(buttoprolol)and group C(suffentanil),32 patients in each group,were given continuous intravenous analgesia after surgery,and the visual analog scores of the three groups were observed at 6,12,24 and 48 h(VAS),Ramsay score and adverse reactions after operation.Results The VAS scores of group B at 6 h,12 h,and 24 h were satisfactory.Within 24 h,the analgesic effect of group A and group C was better than that of group B.At 48 h after operation,the VAS scores of the three groups were good,there was no significant difference(P>0.05);the adverse reaction showed that the total incidence of group A was 15.62%.The total incidence of group B was 31.25%;the total incidence of group C was 37.5%;the incidence of adverse reactions was lower in group A than in group B and C,the difference was statistically significant(χ^2=5.248,P=0.005).Conclusion The efficacy of sufentanil combined with butorphanol for postoperative analgesia in lower extremity fractures is significantly better than that of butorphanol or sufentanil alone.The combined analgesic effect is more obvious and the adverse reactions are more obvious and more secure.