去阿片化镇痛方案在跟骨骨折手术中的临床探讨  

Clinical Study of Deopioid Analgesia in Calcaneal Fracture 0peration

作　　者：陈茜 武斌 CHEN Qian;WU Bin(Department of Anesthesiology,Guangxi Orthopedic Hospital,Nanning,Guangxi Zhuang Autonomous Region,530012 China)

机构地区：[1]广西骨伤医院麻醉科,广西南宁530012

出　　处：《系统医学》2023年第3期51-54,共4页Systems Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题基金资助项目(z20190514)。

摘　　要：目的探讨超声引导下腘窝胫神经阻滞联合去阿片化静脉镇痛泵方案在跟骨骨折患者术后镇痛效果。方法选择2020年7月—2021年7月广西骨伤医院择期行跟骨骨折手术患者80例,随机分为去阿片化组(NO组)和含阿片类药物组(OP组),每组40例。两组术后均在超声引导下行腘窝处胫神经阻滞,记录并比较两组患者术后6、12、24、48 h的VAS评分、术后静脉泵药液使用完毕时间、术后需要镇痛补救药的情况以及术后恶心呕吐不良反应的发生情况。结果NO组术后6、12、24、48 h各时点的VAS评分分别为(0.18±0.38)分、(0.68±0.73)分、(1.68±0.69)分、(1.60±0.55)分,与OP组的(0.13±0.33)分、(0.60±0.71)分、(1.55±0.64)分、(1.38±0.49)分比较,差异无统计学意义(t=0.620、0.466、0.838、1.940,P>0.05)。两组术后静脉泵药液使用完毕时间比较,差异无统计学意义(t=-0.947,P>0.05)。两组术后需要镇痛补救药的情况比较,差异无统计学意义(χ^(2)=0.626,P>0.05)。结论去阿片化镇痛方案在跟骨骨折术后能提供良好的镇痛效果,且不增加不良反应。Objective To investigate the analgesic effect of ultrasound-guided popliteal tibial nerve block combined with deopioid intravenous analgesic pump in postoperative patients with calcaneal fracture.Methods A total of 80 patients undergoing elective calcaneal fracture surgery in Guangxi Orthopedic Hospital from July 2020 to July 2021 were selected and randomly divided into deopioid group(NO group)and opiate containing group(OP group),with 40 cases in each group.Postoperative tibial nerve block in popliteal fossa was performed under ultrasound-guided in both groups.The VAS scores at 6 h,12 h,24 h and 48 h,the postoperative use time of intravenous pump solution,the need for postoperative analgesic remedy and the occurrence of adverse reactions of nausea and vomiting were recorded and compared between the two groups.Results The VAS scores at 6 h,12 h,24 h and 48 h were(0.18±0.38)points,(0.68±0.73)points,(1.68±0.69)points,(1.60±0.55)points,compared with(0.13±0.33)points,(0.60±0.71)points,(1.55±0.64)points,and(1.38±0.49)points of the OP group,and the difference was not statistically significant(t=0.620,0.466,0.838,1.940,P>0.05).There was no statistically significant difference between the two groups of postoperative intravenous pump fluid use time(t=-0.947,P>0.05).There was no statistically significant difference between the two groups in the need for pain relief after surgery(χ^(2)=0.626,P>0.05).Conclusion Deopioid analgesic regimen can provide good analgesic effect after calcaneal fracture without increasing adverse reactions.

关 键 词：跟骨骨折 去阿片化镇痛 超声引导 胫神经阻滞 

分 类 号：R4[医药卫生—临床医学]