布托啡诺对高龄股骨颈骨折患者THR术后Ramsay镇静评分及血清疼痛介质影响研究  

Effects of butorphanol on ramsay sedation score and serum pain medi-ators in elderly patients with Femoral neck fracture after THR

作　　者：何智勇[1] 李开南[1] 彭超[1] 龙涛[1] HE Zhiyong;LI Kainan;PENG Chao;LONG Tao(Department of orthopedics,Affiliated Hospital of Chengdu University,Chengdu Sichuan 610081,China)

机构地区：[1]成都大学附属医院骨科,四川成都610081

出　　处：《中国急救复苏与灾害医学杂志》2021年第9期1043-1046,1056,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家重点研发计划项目(编号:2016YFC0105806)。

摘　　要：目的探讨布托啡诺对高龄股骨颈骨折患者THR术后Ramsay镇静评分及血清疼痛介质影响。方法成都大学附属医院于2017年9月—2019年11月收治的96例高龄股骨颈骨折患者随机分为试验组和对照组,均行全髋关节置换术治疗,试验组术后采用布托啡诺镇痛,对照组采用芬太尼镇痛,比较两组镇静镇痛效果及血清疼痛介质、炎症介质和氧化应激指标变化。结果两组患者术后Ramesay镇静评分升高(P<0.05),VAS评分降低(P<0.05),组间比较试验组Ramesay镇静评分高于对照组(P<0.05),VAS镇痛评分低于对照组(P<0.05);两组患者术后即刻各项疼痛介质PGE2、SP、β-EP水平差异无统计学意义(P>0.05),术后48 h各项指标显著下降(P<0.05),术后48h各项指标比较试验组低于对照组(P<0.05);两组患者术后即刻各项炎症介质IL-6、MCP-1、HMGB-1水平差异无统计学意义(P>0.05),术后48 h各指标较术后即刻显著降低(P<0.05),术后各项指标比较试验组低于对照组(P<0.05);两组患者术后即刻各项氧化应激指标Cu-ZnSOD、GSH-Px、MDA水平差异无统计学意义(P>0.05),术后48 h Cu-ZnSOD、GSH-Px水平较术后即刻显著升高(P<0.05),MDA水平较术后即刻显著降低(P<0.05),术后48 h各项指标比较,试验组Cu-ZnSOD、GSH-Px水平高于对照组(P<0.05),MDA水平低于对照组(P<0.05)。结论高龄股骨颈骨折患者全髋关节置换术后应用布托啡诺能够有效抑制疼痛介质和炎症介质释放,减轻氧化应激程度,镇静、镇痛效果良好,具有较好的应用前景。Objective To investigate the effects of butorphanol on Ramsay Sedation score and serum pain mediators in elderly patients with femoral neck fracture after THR.Methods 96 elderly patients with femoral neck fracture treated in the Affiliated Hospital of Chengdu University from September 2017 to November 2019 were randomly divided into experimental group and control group.All patients were treated with total hip arthroplasty.The experimental group was treated with Butorphanol after operation,and the control group was treated with fentanyl.The sedative and analgesic ef‐fects and the changes of serum pain mediators,inflammatory mediators and oxidative stress indexes were compared be‐tween the two groups.Results After operation,the ramesay sedation score increased(P<0.05)and the VAS score de‐creased(P<0.05).The ramesay sedation score in the experimental group was higher than that in the control group(P<0.05),and the vas analgesia score was lower than that in the control group(P<0.05);There was no significant differ‐ence in the pain mediators PGE2,SP,β-EP level(P>0.05),the indexes decreased significantly at 48 hours after opera‐tion(P<0.05),and the indexes in the experimental group were lower than those in the control group at 48 hours after op‐eration(P<0.05);There was no significant difference in the levels of inflammatory mediators IL-6,MCP-1 and HMGB 1 between the two groups immediately after operation(P>0.05).The indexes at 48 hours after operation were significant‐ly lower than those immediately after operation(P<0.05),and the indexes in the experimental group were lower than those in the control group(P<0.05);There was no significant difference in the levels of Cu-Zn SOD,GSH-PX and MDA between the two groups immediately after operation(P>0.05).The levels of Cu-Zn SOD and GSH-PX were signif‐icantly higher than those immediately after operation(P<0.05),and the level of MDA was significantly lower than those immediately after operation(P<0.05).The levels of Cu-Zn SOD and GSH-PX in the experimental g

关 键 词：布托啡诺 高龄股骨颈骨折 全髋关节置换术 RAMSAY镇静评分 

分 类 号：R614[医药卫生—麻醉学]