口服氨酚羟考酮联合硬膜外镇痛在下肢骨折术后镇痛中的应用  

Application of oral oxycodone and ace taminophen combined with epidural analgesia in postoperative analgesia of lower limb fracture

作　　者：吴雪 卢军杰[2] 凌刚 赵本坤 郭强 乔国宏[2] 冉红 党彩艳 WU Xue;LU Junjie;LING Gang;ZHAO Benkun;GUO Qiang;QIAO Guohong;RAN Hong;DANG Caiyan(Department of Anesthesiology,Pingli County Hospital,Shaanxi,Pingli 725500,China;Department of Anesthesiology,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University Health Science Center,Shaanxi,Xi'an 710003,China;Department of Pain,Xi'an Central Hospital Affiliated to Xi'an Jiaotong University Health Science Center,Shaanxi,Xi'an 710003,China)

机构地区：[1]陕西省平利县医院麻醉科,陕西平利725500 [2]西安交通大学医学院附属西安市中心医院麻醉科,陕西西安710003 [3]西安交通大学医学院附属西安市中心医院疼痛科,陕西西安710003

出　　处：《中国医药科学》2020年第14期112-115,151,共5页China Medicine And Pharmacy

摘　　要：目的 观察口服氨酚羟考酮联合硬膜外镇痛用于下肢骨折内固定术后的镇痛效果.方法 选取下肢骨折内固定术后患者60例,随机分为两组,每组30例.两组硬膜外镇痛方案相同,即0.75%罗哌卡因20mL+地佐辛10mg+生理盐水至100mL.观察组术后4h开始口服氨酚羟考酮5mg,一日3次,对照组仅行硬膜外镇痛.记录术后4、8、12、24、48h静息和活动时的VAS和镇静评分,评估术后24、48h总体满意度,评估镇痛优良比率和不良反应.结果 与对照组比较,观察组术后8、12、24、48h静息和活动时VAS评分均显著降低(P<0.05),术后24、48h总体满意度和镇痛优良比率均显著提高(P<0.05).两组间镇静评分和不良反应差异无统计学意义(P>0.05).结论 口服氨酚羟考酮联合硬膜外镇痛可显著减轻下肢骨折内固定术后疼痛,活动镇痛效果优良,总体满意度高.Objective To observe the analgesic effect of oral oxycodone and acetaminophen combined with epidural analgesia after lower limb fracture internal fixation. Methods 60 patients with lower limb fractures after internal fixation were randomly divided into two groups,with 30 cases in each group.The same epidural analgesia regimen was performed in two groups,namely 0.75% ropivacaine 20 mL + dezocine 10 mg + physiological saline totaling 100 mL.The observation group was given oxycodone and acetaminophen 5 mg 4 hours after surgery,3 times a day,and the control group only received epidural analgesia.The visual analogue scale(VAS) and sedation scores at rest,activity at 4,8,12,24 and 48 hours after operation were recorded;the overall satisfaction at 24 and 48 hours after operation was evaluated;the analgesic excellent rate and adverse reactions were evaluated. Results Compared with the control group,the VAS scores of the rest and activity at 8,12,24 and 48 hours of the observation group after operation were significantly decreased(P < 0.05),and the overall satisfaction and analgesic excellent ratio at 24 and 48 hours after operation were significantly improved(P < 0.05).There was no significant difference in sedation scores and adverse reactions between the two groups(P > 0.05). Conclusion Oral oxycodone and acetaminophen combined with epidural analgesia can significantly reduce the postoperative pain of lower limb fracture internal fixation,with excellent analgesic effect and high overall satisfaction.

关 键 词：氨酚羟考酮 硬膜外镇痛 下肢骨折 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]