纳布啡用于老年股骨颈骨折术后镇痛的效果

Effect of nalbuphine on postoperative analgesia in elderly patients with femoral neck fractures

目的观察纳布啡用于老年股骨颈骨折术后镇痛的临床效果。方法选择2019年3月—2021年3月江阴临港医院收治的老年股骨颈骨折患者80例,均行髋关节置换术,采用随机数字表法分为研究组和对照组,每组40例。对照组术毕硬膜外腔注射舒芬太尼0.1μg/kg(生理盐水稀释至5 ml),术后行静脉自控镇痛(PCIA):舒芬太尼2μg/kg+托烷司琼10 mg+生理盐水至100 ml;研究组术毕硬膜外腔注射纳布啡0.1 mg/kg(生理盐水稀释至5 ml),术后行PCIA:纳布啡1 mg/kg+舒芬太尼1μg/kg+托烷司琼10 mg+生理盐水至100 ml。比较2组患者术后6 h、12 h、24 h、48 h视觉模拟评分法(VAS)评分和Ramsay评分及不良反应。结果2组患者术后6 h、48 h VAS评分比较差异均无统计学意义(P>0.05);研究组患者术后12 h、24 h VAS评分均低于对照组(P<0.05);研究组患者术后6 h、12 h、24 h、48 h Ramsay评分均高于对照组(P<0.05);研究组患者不良反应总发生率为5.00%,低于对照组的20.00%(χ^(2)=4.114,P=0.043)。结论纳布啡可减轻老年股骨颈骨折手术患者的术后疼痛,提高镇静效果,降低不良反应。

Objective To observe the clinical effect of nalbuphine on postoperative analgesia in elderly patients with femoral neck fractures.Methods 80 cases of elderly patients with femoral neck fracture admitted to Jiangyin Lingang Hospital from March 2019 to March 2021 were selected,all underwent hip replacement,and they were divided into study group and control group by random number table method,with 40 cases in each group.At the end of operation,the control group received epidural injection of sufentanil 0.1μg/kg(diluted to 5 ml with normal saline),then patient controlled intravenous analgesia(PCIA)was performed postoperatively:sufentanil 2μg/kg+tropisetron 10 mg+normal saline to100 ml;In the study group,nalbuphine 0.1 mg/kg was injected into epidural space(diluted to 5 ml with normal saline),and PCIA was performed after operation:nalbuphine 1 mg/kg+sufentanil 1μg/kg+tropisetron 10 mg+normal saline to 100 ml.The VAS scores,Ramsay scores and adverse reactions were compared between the two groups at 6 h,12 h,24 h and 48 h after operation.Results There were no significant difference in VAS scores between the two groups at 6 h and 48 h after operation(P>0.05).The VAS scores of the study group at 12 h and 24 h after operation were lower than those in the control group(P<0.05);The Ramsay scores of the patients in the study group were higher than those in the control group at 6 h,12 h,24 h and 48 h after operation(P<0.05);The total incidence of adverse reactions in the study group was 5.00%,which was lower than 20.00% in the control group(χ^(2)=4.114,P=0.043).Conclusion Nalbuphine can reduce postoperative pain in elderly patients with femoral neck fracture surgery,improve sedative effect,and reduce adverse reactions.