氢吗啡酮与舒芬太尼多模式镇痛在下肢骨折中的应用  

Application of Hydromorphone And Sufentanidol Mode Analgesia in Lower Limb Fracture

作　　者：戴萍[1] 蒋奇明 封琴 顾云峰[1] 贾静 DAI Ping;JIANG Qiming;FENG Qin;GU Yunfeng;JIA Jing(Department of Anesthesiology,the Third People's Hospital of Taizhou City,Taizhou Jiangsu 225321,China)

机构地区：[1]江苏省泰州市第三人民医院麻醉科,江苏泰州225321

出　　处：《中国继续医学教育》2021年第32期158-162,共5页China Continuing Medical Education

摘　　要：目的对氢吗啡酮与舒芬太尼在下肢骨折患者进行多模式镇痛中的镇痛效果对比。方法以2018年6月—2020年12月于本院接收的60例下肢骨折患者作为研究对象,依据随机数字表法,分组舒芬太尼(SF)组(共30例患者)和氢吗啡酮(HM)组(共30例患者),SF组术中舒芬太尼硬膜外给药超前镇痛联合术后舒芬太尼静脉自控镇痛,HM组术中氢吗啡酮硬膜外给药超前镇痛联合术后氢吗啡酮静脉自控镇痛,对两组干预后的视觉模拟评分法(VAS)评分、Ramsay镇静评分、不良反应发生情况等进行分析。结果HM组下肢骨折患者术后6 h、12 h、24 h的VAS评分均低于SF组(P<0.05);HM组术后6 h、12 h、24 h的Ramsay镇静评分高于SF组(P<0.05);HM组不良反应发生率为10.00%,低于SF组不良反应发生率33.33%,差异有统计学意义(P<0.05)。结论相较于舒芬太尼,氢吗啡酮多模式镇痛应用于下肢骨折患者中,有着更好的镇痛、镇静效果,且安全有效,意义重大。Objective To compare the analgesic effect of hydromorphone and sufentanil in multimodal analgesia for patients with lower limb fracture.Methods 60 patients with lower limb fractures received in our hospital from June 2018 to December 2020 were selected as the research objects.According to the random number table method,they were divided into sufentanil(SF)group(30 patients in total)and hydromorphone(HM)group(30 patients in total).In SF group,sufentanil epidural administration was preemptive analgesia+postoperative sufentanil intravenous patient-controlled analgesia,while in HM group,hydromorphone epidural administration was preemptive The visual analogue scale(VAS)score,Ramsay Sedation score and the incidence of adverse reactions were analyzed.Results The VAS scores of lower limb fracture patients in HM group were lower than those in SF group at 6 h,12 h and 24 h after operation(P<0.05);the Ramsay Sedation scores of HM group at 6h,12h and 24h after operation were higher than those in SF group(P<0.05);the incidence of adverse reactions in HM group was 10.00%,which was lower than that in SF group(33.33%),and the difference was statistically significant(P<0.05).Conclusion Compared with sufentanil,hydromorphone multimodal analgesia in patients with lower limb fracture has better analgesic and sedative effect,and is safe and effective,which is of great significance.

关 键 词：氢吗啡酮 舒芬太尼 下肢骨折 多模式镇痛 硬膜外超前镇痛 术后静脉自控镇痛 

分 类 号：R614[医药卫生—麻醉学]