鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折PFNA内固定术患者的镇痛效果及安全性对比

Comparison of Analgesic Effect and Safety of Intravaginal Injection of Sufentanil and Fentanyl in Elderly Patients with Intertrochanteric Fractures under PFNA Internal Fixation

目的:对比鞘内注射舒芬太尼与芬太尼对高龄股骨粗隆骨折近端股骨钉抗旋(PFNA)内固定术患者的镇痛效果及安全性对比。方法:选取2019年1月—2022年12月于常熟市第五人民医院接受股骨粗隆骨折PFNA内固定术的108例高龄患者作为研究对象,根据随机数表法将患者分为研究组54例与常规组54例。研究组采用鞘内注射舒芬太尼,常规组采用鞘内注射芬太尼。比较两组手术时间、镇痛时间、术后6 h、12 h视觉模拟评分法(VAS)评分及不良反应发生情况。结果:两组手术时间比较,差异无统计学意义(P>0.05);研究组镇痛时间长于常规组,差异有统计学意义(P<0.05)。研究组术后6 h、12 h VAS评分低于常规组,且两组术后12 h VAS评分低于术后6 h,差异有统计学意义(P<0.05)。研究组不良反应发生率低于常规组,差异有统计学意义(P<0.05)。结论:相比芬太尼,舒芬太尼在高龄股骨粗隆骨折PFNA内固定术患者中的镇痛作用显著,能缓解术后疼痛,还可降低不良反应发生率。

Objective:To compare the analgesic effect and safety of intrathecal injection of Sufentanil and Fentanyl in elderly patients with intertrochanteric fractures under proximal femoral nail antirotation(PFNA)internal fixation.Method:A total of 108 elderly patients with intertrochanteric fractures under PFNA internal fixation who treated in the the Fifth People's Hospital of Changshu from January 2019 to December 2022 were selected as the research objects,the patients were divided into 54 cases in the study group and 54 cases in the conventional group according to the random number table method.The study group was treated with intrathecal injection of Sufentanil,and the conventional group was treated with intrathecal injection of Fentanyl.The operation time,analgesia time,visual analogue scale(VAS)score at 6 h and 12 h after operation and adverse reactions were compared between two groups.Result:There was no significant difference in the operation time between two groups(P>0.05);the analgesic time of the study group was longer than that of the conventional group,and the difference was statistically significant(P<0.05).The VAS scores of the study group at 6 h and 12 h after operation were lower than those of the conventional group,and the VAS scores of two groups at 12 h after operation were lower than those at 6 h after operation,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion:Compared with Fentanyl,Sufentanil has a significant analgesic effect in elderly patients undergoing PFNA internal fixation for intertrochanteric fractures,which can relieve postoperative pain and reduce the incidence of adverse reactions.