国产盐酸罗哌卡因在老年下肢骨折患者术后镇痛中的效果及其对血清指标的影响  

Study on the Effect of Domestic Ropivacaine Hydrochloride in Treating Postoperative Analgesia among Elderly Patients with Lower Limb Fracture and its Influence on Their Serum Indexes

作　　者：孟雅静[1] 梁小青[1] 杜淑娟[1] 高金贵[1] 

机构地区：[1]石家庄市中心医院麻醉科,石家庄050011

出　　处：《医学综述》2014年第18期3433-3435,共3页Medical Recapitulate

摘　　要：目的探讨国产盐酸罗哌卡因在老年下肢骨折患者术后镇痛中的效果及其对血清指标的影响。方法选取2011年1月至2012年7月于石家庄市中心医院进行手术治疗的68例老年下肢骨折患者为研究对象,将其按照随机数字表法分为国产布比卡因治疗组(布比卡因组)和国产盐酸罗哌卡因治疗组(罗哌卡因组),每组各34例。布比卡因组术后给予20 mL国产0.75%布比卡因、0.4 mg芬太尼和氟哌利多混合液,将其采用术后留置自控镇痛泵进行术后镇痛。罗哌卡因组术后给予20 mL国产罗哌卡因、0.4 mg芬太尼和氟哌利多混合液,将其采用术后留置自控镇痛泵进行术后镇痛。并对两组患者不同时间段的疼痛评分、血液流变学指标、炎性指标、应激指标及不良反应发生率进行比较。结果罗哌卡因组术后4、12、24 h的疼痛评分均低于布比卡因组(1.30±0.20)分vs(1.80±0.40)分、(2.00±0.50)分vs(3.40±0.70)分、(1.50±0.30)分vs(2.20±0.50)分,均P<0.05);术后4、12、24 h,罗哌卡因组血液流变学指标、炎性指标及应激指标均低于布比卡因组。布比卡因组患者发生皮肤瘙痒2例(5.88%),恶心1例(2.94%),罗哌卡因组仅1例患者发生皮肤瘙痒(2.94%)。结论国产盐酸罗哌卡因在老年下肢骨折患者术后镇痛中的效果较好,且对其血清指标的不良影响也更小。Objective To study the effect of domestic ropivacaine hydrochloride in treating postoperative analgesia among elderly patients with lower limb fracture and its influence on the serum indexes.Methods A total of 68 elderly patients with lower limb fracture treated with surgery in Shijiazhuang Centerm Hospital from Jan.2011 to Jul.2012 were selected as subjects and randomly divided into domestic bupivacaine group and domestic ropivacaine hydrochloride group according to random number table,with 34 cases in each group.Patients in domestic bupivacaine group were administrated with 20 mL 0.75% domestic bupivacaine,0.4 mg fentanyl and droperidol with PCEA,and patients in domestic ropivacaine hydrochloride group were administrated with 20 mL 0.75% domestic ropivacaine hydrochloride,0.4 mg fentanyl and droperidol with PCEA after operation.The pain score,hemorheology indexes,inflammatory indexes and stress indexes at different times as well as the incidence of adverse reactions of the two groups were compared.Results The pain scores of domestic ropivacaine hydrochloride group after the surgery at different times（4,12 and 24 h after operation） were lower than those of domestic bupivacaine group （1.30±0.20 vs 1.80 ±0.40,2.00 ±0.50 vs3.40±0.70,1.50±0.30 vs2.20±0.50,P〈0.05）;H emorheology indexes,inflammatory indexes and stress indexes of domestic bupivacaine group were lower than those of domestic bupivacaine group 4,12 and 24 h after operation.Two cases of skin pruritus （5.88 %） and one case of nausea （2.94%） occurred in domestic bupivacaine group,while only one case of skin pruritus （2.94 %） occurred in domestic ropivacaine hydrochloride group.Conclusion The effect of domestic ropivacaine hydrochloride in treating postoperative analgesia among elderly patients with lower limb fracture is better,and the advmse influence on the serum indexes is minor.

关 键 词：国产盐酸罗哌卡因 老年下肢骨折 术后镇痛 效果 血清指标 

分 类 号：R614.3[医药卫生—麻醉学]