舒芬太尼对关节镜下跟骨骨折复位固定术后镇痛和谵妄的影响

Effects of Sufentanil on Postoperative Analgesia and Delirium after Calcaneal Fracture Reduction and Fixation Assisted by Arthroscope

目的:探讨舒芬太尼静脉自控镇痛对关节镜辅助下跟骨骨折复位固定术后镇痛和谵妄的影响。方法:将行关节镜辅助下跟骨骨折复位固定术的74例患者随机均分为对照组和观察组,对照组采用芬太尼静脉自控镇痛,观察组患者采用舒芬太尼静脉自控镇痛;比较2组患者术后镇静评分、镇痛评分,48 h内不良反应发生情况及术后1周内谵妄发生率。结果:观察组患者术后48 h内5个时间点(2、4、8、24及48 h)的镇痛和镇静评分均明显低于对照组,差异有统计学意义(P<0.05);术后48 h内,对照组与观察组不良反应发生率分别为29.73%、10.81%,2组比较差异有统计学意义(χ2=10.3781,P<0.001);2组患者术后1周谵妄发生率比较,差异无统计学意义(χ2=1.0142,P=0.314)。结论:舒芬太尼静脉自控镇痛对关节镜辅助下跟骨骨折复位固定术后镇痛和镇静的效果优于芬太尼静脉自控镇痛,但对术后谵妄的发生率无影响。

Objective:To investigate the effect of sufentanil intravenously controlled analgesia on postoperative analgesia and delirium after arthroscope-assisted calcaneal fractures reduction and fixation.Methods:74 patients of arthroscope-assisted calcaneal fractures reduction and fixation were selected as the subjects.The patients were randomly divided into control group and observation group with 37 cases in each group.The patients in the observation group were treated with sufentanil intravenous analgesia and the control group with fentanil intravenous analgesia.The incidence of postoperative sedation,analgesia,adverse reactions within 48 hours and delirium within 1 week were compared between the two groups.Results:The analgesia and sedation of patients were compared at 5 time points(2,4,8,24,and 48 h)within 48 hours after operation.Results showed that the analgesic and sedative scores of the patients in the observation group were lower than those in the control group at each time point,and the difference was statistically significant(P<0.05).During the 48 hours after operation,the incidence of adverse reactions in the control group and the observation group was 29.73%and 10.81%respectively,which was statistically significant(χ2=10.3781,P<0.001).There was no significant difference in postoperative delirium within 1 week between the two groups(χ2=1.0142,P=0.314).Conclusion:Sufentanil intravenously controlled analgesia has better analgesic effect while has fewer effect on postoperative delirium for patients of arthroscopic-assisted calcaneal fractures reduction and fixation operation.