普瑞巴林对老年髋关节置换术后疼痛的影响

Influence of Pregabalin on Postoperative Pain in Elderly Patients Undergoing Hip Replacement

目的:探讨普瑞巴林对老年髋关节置换术后疼痛的影响。方法:选取2018年6月—2020年5月本院收治的84例拟行髋关节置换术治疗的老年患者,随机分为观察组与对照组,各42例。对照组术后常规静脉自控镇痛(PCIA),观察组在对照组基础上另给予普瑞巴林。比较两组体质量以及术后48h内舒芬太尼总用量、右美托咪定总用量,对比术后12h、24h、48h的面部表情疼痛量表(FPS-R)评分、舒适度(BCS)评分,并对比自控镇痛泵(PCA)按压次数及补救镇痛情况,另对比不良反应发生情况。结果:观察组体质量及术后48h内舒芬太尼总用量、右美托咪定总用量与对照组比较,差异均无统计学意义(P>0.05);FPS-R评分及BCS评分组间、时间、交互方面比较差异均有统计学意义(P<0.05);两组术后24h、术后48h FPS-R评分均低于术后12h,术后48h FPS-R评分均低于术后24h,观察组术后12h、24h、48h FPS-R评分均低于对照组,差异均有统计学意义(P<0.05);两组术后24h、术后48h BCS评分均高于术后12h,术后48h BCS评分均高于术后24h,观察组术后12h、24h、48h BCS评分均高于对照组,差异均有统计学意义(P<0.05);观察组镇痛泵按压次数少于对照组,补救镇痛率低于对照组,差异均有统计学意义(P<0.05);两组不良反应均轻微,不良反应发生率比较差异无统计学意义(P>0.05)。结论:老年髋关节置换术后在常规镇痛基础上,另加普瑞巴林可减轻术后疼痛,增强舒适度,减少镇痛泵按压次数和补救镇痛,且安全性较高。

Objective: To explore the influence of pregabalin on postoperative pain in elderly patients undergoing hip replacement. Methods: 84 elderly patients to be treated with hip replacement in our hospital from June 2018 to May 2020 were selected, who were randomly divided into observation group and control group, with 42 cases in each group. The control group was given conventional patient controlling intravenous analgesia(PCIA), while the observation group was given pregabalin on the basis of the control group. The body weight and the total dosage of sufentanil and dexmedetomidine within 48 hours after operation were compared between the two groups, and the faces pain scale-Revised(FPS-R) score and comfort score(BCS) were compared at 12 hours, 24 hours and 48 hours after operation, and the times of compression of PCEA pump(PCA) and the situation of remedial analgesia were compared, and the adverse reactions were also compared. Results: There was no significant difference in body mass, total dosage of sufentanil and total dosage of dexmedetomidine within 48 hours after operation between the observation group and control group(P>0.05). There were significant differences in FPS-R scores and BCS scores between groups, moments and interactions(P<0.05). The FPS-R scores in the two groups at 24 hours and 48 hours after operation were lower than those at 12 hours, which at 48 hours after operation were lower than those at 24 hours, and the FPS-R scores in the observation group at 12 hours, 24 hours and 48 hours after operation were lower than those in the control group, with statistically significant differences(P<0.05). The BCS scores in the two groups at 24 hours and 48 hours after operation were higher than those at 12 hours, which at 48 hours after operation were higher than those at 24 hours, and the BCS scores in the observation group at 12 hours, 24 hours and 48 hours after operation were higher than those in the control group, with statistically significant differences(P<0.05). The times of pressing analgesia pump in the observation group was less than that in the control group, and the rate of remedial analgesia was lower than that in the control group, with statistically significant differences(P<0.05). The adverse reactions were slight in both groups, and there was no significant difference in the incidence rate of adverse reactions(P>0.05). Conclusion: On the basis of routine analgesia in elderly patients after hip replacement, adding pregabalin can reduce the postoperative pain, enhance the comfort, reduce the times of pressing the analgesia pump and remedy the pain, with higher safety.