盐酸羟考酮联合帕瑞昔布钠在老年股骨骨折术患者镇痛中的应用效果

Application effects of Oxycodone hydrochloride combined with Parecoxib sodium in postoperative analgesia of elderly patients with femoral fractures

目的:观察盐酸羟考酮联合帕瑞昔布钠在老年股骨骨折术患者镇痛中的应用效果。方法:回顾性分析2019年4月至2020年4月该院收治的94例老年股骨骨折患者的临床资料,按照使用镇痛药物不同将其分为对照组和观察组各47例。两组均行内固定术治疗,并进行全身麻醉,对照组采用帕瑞昔布钠镇痛,观察组在对照组基础上联合盐酸羟考酮镇痛。比较两组术前和术后12、24 h疼痛程度[视觉模拟评分法(VAS)]评分,术后12、24、48 h镇静程度[Ramsay镇静评分法]评分,术前和术后12 h应激指标[肾上腺素(E)、去甲肾上腺素(NE)]水平,以及不良反应发生率。结果:术后12、24 h,观察组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后12、24、48 h,观察组Ramsay评分均高于对照组,差异有统计学意义(P<0.05);术后12 h,观察组E、NE水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:盐酸羟考酮联合帕瑞昔布钠应用于老年股骨骨折术患者可提高术后镇痛、镇静效果,降低应激指标水平,效果优于单纯帕瑞昔布钠镇痛。

Objective:To observe application effects of Oxycodone hydrochloride combined with Parecoxib sodium in postoperative analgesia of elderly patients with femoral fractures.Methods:The clinical data of 94 elderly patients with femoral fractures admitted to the hospital from April 2019 to April 2020 were retrospectively analyzed.They were divided into control group and observation group according to different analgesic drugs,47 cases each.Both groups were treated with internal fixation and general anesthesia.The control group was treated with Parecoxib sodium for analgesia,while the observation group was combined with Oxycodone hydrochloride for analgesia on the basis of that of the control group.The pain degree scores[visual analogue scale(VAS)]before and 12 and 24 h after the surgery,the sedation degree scores[Ramsay sedation score]12,24 and 48 h after the surgery,the levels of stress indexes[epinephrine(E)and norepinephrine(NE)]before and 12 h after the surgery,and the incidence of adverse reactions were compared between the two groups.Results:12 and 24 h after the surgery,the VAS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).12,24 and 48 h after the surgery,the Ramsay scores of the observation group were higher than those of the control group,and the differences were statistically significant(P<0.05).12 h after the surgery,the levels of E and NE in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Oxycodone hydrochloride combined with Parecoxib sodium in the elderly patients after femoral fracture surgeries can improve the postoperative analgesia and sedation,and reduce the levels of stress indexes.Moreover,it is superior to single Parecoxib sodium analgesia.