耳穴压豆辅助右美托咪定对老年股骨骨折患者术后镇痛效果的观察

Observation of Auricular Pressure Combined with Dexmedetomidine on Postoperative Analgesia in Elderly Patients with Femoral Fracture

目的:探究耳穴压豆辅助右美托咪定对老年股骨骨折患者术后镇痛的临床效果。方法:将老年股骨骨折患者60例随机等分为3组,对照组术后行舒芬太尼2μg/kg静脉自控镇痛(PCIA),观察1组、观察2组术后行右美托咪定2μg/kg联合舒芬太尼2μg/kg PCIA,观察2组并辅助耳穴压豆,比较各组镇痛效果。结果:术后1 h、6 h、24 h,观察1组、观察2组VAS评分均显著低于对照组,术后24 h,观察2组VAS评分显著低于观察1组,术后24 h,三组患者VAS评分均较治疗前显著降低;观察1组、观察2组术后24 h PQSI评分均显著低于对照组,且观察2组PQSI评分低于观察1组;观察1组、观察2组镇痛泵按压次数均显著低于对照组,且观察2组镇痛泵按压次数低于观察1组;观察1组、观察2组术后1 h血糖及术后24 h CRP水平较对照组均降低,且观察2组血糖及CRP低于观察1组。结论:耳穴压豆辅助右美托咪定能增强舒芬太尼的镇痛镇静效果,并能进一步改善患者的术后睡眠质量。

Objective To explore the clinical effect of auricular pressure combined with Dexmedetomidine on postoperative analgesia in elderly patients with femoral fracture.Methods Sixty elderly patients with femoral fracture were randomly divided into three groups.Control group was given postoperative 2μg/kg Sufentanil PCIA,Observation group 1 and 2 were given postoperative 2μg/kg Sufentanil+2.5μg/kg Dexmedetomidine PCIA,and Observation group 2 was assisted with auricular pressure.The analgesic effect of each group were compared.Results The VAS scores in Observation group 1 and 2 after surgery for 1 h,6 h,24 h were significantly lower than those of the Control group.The VAS scores in Observation group 2 after surgery for 24 h were significantly lower than those of the Observation group 1.The VAS scores in three groups after surgery for 24 h were significantly lower than those before treatment.The PQSI scores of Observation group 1 and Observation group 2 after surgery for 24 h were significantly lower than those of the Control group,and the PQSI score in Observation group 2 decreased more significantly.The times of analgesia pump pressure in Observation group 1 and 2 were significantly lower than those in the Control group,and Observation group 2 analgesia pump pressure times decreased more obviously.The blood glucose at 1 h and CRP at 24 h after operation in Observation group 1 and 2 were lower than those in the Control group,and the reduction was more obvious in Observation group 2.Conclusion Auricular pressure combined with Dexmedetomidine can enhance the analgesic and sedative effect of Sufentanil and improve postoperative sleep quality.