羟考酮与舒芬太尼在老年股骨转子间骨折患者PFNA内固定术中的应用效果对比  

Comparison of the application effect of oxycodone and sufentanil in PFNA internal fixation in elderly patients with intertrochanteric fracture of femur

作　　者：吴维强[1] 姚泽宇[1] 王学军[1] WU Wei-qiang;YAO Ze-yu;WANG Xue-jun(Department of Anesthesiology,Qinghai Red Cross Hospital,Xining Qinghai 810099,China)

机构地区：[1]青海红十字医院麻醉科,青海西宁810099

出　　处：《局解手术学杂志》2022年第6期515-519,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：青海省科技计划项目(2019-ZJ-7085)。

摘　　要：目的比较羟考酮与舒芬太尼在老年股骨转子间骨折患者股骨近端防旋髓内钉(PFNA)内固定术中的应用效果。方法选取我院收治的股骨转子间骨折并择期行PFNA内固定术的患者92例,采用随机数字表法分为舒芬太尼组(采用舒芬太尼+常规麻醉,46例)和羟考酮组(采用羟考酮+常规麻醉,46例)。比较2组患者麻醉药物使用量、手术时间、术中出血量及苏醒时间;比较2组患者麻醉前、麻醉即刻、手术20 min、手术结束即刻的收缩压(SBP)、舒张压(DBP)及心率(HR);比较2组患者苏醒即刻、术后1 h、术后6 h的视觉模拟量表(VAS)评分;比较2组患者苏醒期躁动发生率及麻醉药物相关不良反应发生率。结果2组患者麻醉药物使用量、手术时间、术中出血量、苏醒时间比较差异均无统计学意义(P>0.05)。2组患者SBP、DBP及HR组间、时间、交互对比差异均有统计学意义(P<0.05);与舒芬太尼组相比,羟考酮组SBP、DBP及HR波动幅度均较小(P<0.05);羟考酮组手术20 min、手术结束即刻SBP、DBP及HR均低于舒芬太尼组(P<0.05)。2组患者VAS评分组间、时间、交互对比差异均有统计学意义(P<0.05);与苏醒即刻相比,2组患者术后1 h、术后6 h的VAS评分均降低(P<0.05);与术后1 h相比,2组患者术后6 h的VAS评分均降低(P<0.05);羟考酮组术后1 h、术后6 h的VAS评分均低于舒芬太尼组(P<0.05)。羟考酮组苏醒期躁动发生率低于舒芬太尼组(P<0.05);2组患者麻醉药物相关不良反应发生率比较差异无统计学意义(P>0.05)。结论在老年股骨转子间骨折患者PFNA内固定术中,羟考酮与舒芬太尼苏醒时间和安全性相当,其中羟考酮能减轻术中血流动力学指标波动,缓解疼痛,降低苏醒期躁动发生率,较舒芬太尼更具优势。Objective To compare the application effect of oxycodone and sufentanil in proximal femoral nail antirotation(PFNA)internal fixation in elderly patients with intertrochanteric fracture of femur.Methods A total of 92 patients with intertrochanteric fracture of femur who underwent elective PFNA internal fixation in our hospital were selected and divided into the sufentanil group(sufentanil+routine anesthesia,46 cases)and the oxycodone group(oxycodone+routine anesthesia,46 cases)according to the random number table method.The anesthetic dosage,operation time,intraoperative blood loss and recovery time of the two groups were compared.The systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)before anesthesia,immediately after anesthesia,20 minutes after operation and immediately after operation of the two groups were compared.The visual analogue scale(VAS)scores immediately after awakening,1 hour after operation and 6 hours after operation of the two groups were compared.The incidences of emergence agitation and anesthetic-related adverse reactions of the two groups were compared.Results There was no statistically significant difference in the anesthetic dosage,operation time,intraoperative blood loss and recovery time between the two groups(P>0.05).There were statistically significant differences in the SBP,DBP and HR between groups,moments and interaction(P<0.05);the fluctuations of SBP,DBP and HR in the oxycodone group were smaller than those in the sufentanil group(P<0.05);the SBP,DBP and HR 20 minutes after operation and immediately after operation in the oxycodone group were lower than those in the sufentanil group(P<0.05).There were statistically significant differences in VAS scores between groups,moments and interaction(P<0.05);the VAS scores 1 hour after operation and 6 hours after operation in both groups were lower than those immediately after awakening(P<0.05);the VAS scores 6 hours after operation in both groups were lower than those 1 hour after operation(P<0.05);the VAS scores 1

关 键 词：羟考酮 舒芬太尼 老年 股骨转子间骨折 股骨近端防旋髓内钉 内固定术 

分 类 号：R614.3[医药卫生—麻醉学]