地佐辛联合昂丹司琼治疗肱骨近端骨折术后疼痛的临床疗效观察

Clinical Observation of Dezocine Combined with Ondansetron in the Treatment of Postoperative Pain in Proximal Humerus Fracture

目的观察地佐辛联合昂丹司琼治疗肱骨近端骨折(PHF)术后疼痛的临床疗效。方法选择2019年11月至2021年10月于宜春市中医院治疗的86例PHF患者,按随机数字表法将其分为两组,各43例。对照组采用舒芬太尼+昂丹司琼术后静脉自控镇痛(PCIA),观察组采用地佐辛+昂丹司琼术后PCIA。比较两组镇痛、镇静效果、PCIA按压次数、P物质(SP)、5-羟色胺(5-HT)及不良反应。结果观察组术后2 h、12 h时Ramsay评分[(2.91±0.60)分、(2.75±0.49)分]低于对照组,呼吸抑制发生率(4.65%)低于对照组(P<0.05);两组术后2 h、12 h时视觉模拟评分法(VAS)评分、PCIA按压次数及术后SP、5-HT、恶心、呕吐发生率比较,差异无统计学意义(P>0.05)。结论地佐辛联合昂丹司琼用于PHF患者术后镇痛、镇静效果确切,且呼吸抑制发生率低,临床应用安全性高,可为PHF患者术后镇痛管理提供指导。

Objective To observe the clinical effect of dezocine combined with ondansetron in the treatment of postoperative pain in proximal humerus fracture(PHF).Methods A total of 86 patients with PHF who were treated in Yichun Hospital of Traditional Chinese Medicine from November 2019 to October 2021 were selected and divided into two groups according to the random number table method,with 43 cases in each group.The control group received sufentanil+ondansetron postoperative patient-controlled intravenous analgesia(PCIA)for analgesia,while the observation group received dezocine+ondansetron postoperative PCIA analgesia.The analgesic,sedative effects,PCIA pressing times,substance P(SP),serotonin(5-HT)and adverse reactions were compared between the two groups.Results The Ramsay score[(2.91±0.60)points,(2.75±0.49)points]of the observation group was lower than that of the control group at 2 h and 12 h after the operation,and the incidence of respiratory depression(4.65%)was lower than that of the control group(P<0.05).There was no significant difference in the visual analogue scale(VAS)score,the number of PCIA compressions and the incidence of postoperative SP,5-HT,nausea and vomiting between the two groups at 2 h and 12 h after operation(P>0.05).Conclusion Dezocine combined with ondansetron for postoperative analgesia and sedation in PHF patients is effective in postoperative analgesia,with low incidence of respiratory depression and high clinical safety,which can provide guidance for postoperative analgesia management in PHF patients.