术中舒芬太尼硬膜外给药超前镇痛+术后舒芬太尼静脉自控镇痛对下肢骨折患者的镇痛效果分析  

Analgesic effect of preemptive analgesia with intraoperative sufentanil epidural administration and patient⁃controlled intravenous analgesia with postoperative sufentanil on patients with lower limb fracture

作　　者：胡宇飞 Hu Yufei(Yongcheng Central Hospital,Henan Province,Shangqiu,Henan 476600)

机构地区：[1]河南省永城市中心医院,河南商丘476600

出　　处：《辽宁医学杂志》2023年第5期62-65,共4页Medical Journal of Liaoning

摘　　要：目的探究术中舒芬太尼硬膜外给药超前镇痛+术后舒芬太尼静脉自控镇痛对下肢骨折患者的镇痛效果分析。方法选取我院2018年5月至2021年4月收治的86例下肢骨折行手术患者列为研究对象,按照随机数字表法分为观察组和对照组,各43例,对照组采用术后舒芬太尼静脉自控镇痛,观察组在对照组的基础上采用术前15分钟采用舒芬太尼硬膜外超前镇痛。比较两组患者术后不同时间视觉模拟评分法(visual analogue scale,Score,VAS)评分、不良反应发生率、Ramsay评分及生命体征变化。结果观察组患者术后0h、4h、8h、12h各时间点VAS评分均低于对照组,差异具有统计学意义(P<0.05)。观察组不良反应生率9.30%低于对照组不良反应发生率27.90%,差异有统计学意义(P<0.05)。术后各时间点观察组Ramsay评分均高于对照组,差异有统计学意义(P<0.05);术后各时间点两组患者SpO_(2)、R、PETCO_(2)比较,无统计学意义(P>0.05)。结论术中舒芬太尼硬膜外给药超前镇痛+术后舒芬太尼静脉自控镇痛有效提高下肢骨折患者术后镇静、镇痛效果,降低不良反应发生率,值得临床推广使用。Objective To explore the role of preemptive analgesia with intraoperative sufentanil epidural administration+postoperative sufentanil intravenous patient⁃controlled analgesia in patients with lower extremity fractures.Methods Eighty⁃six patients with lower limb fracture who underwent surgery in our hospital from May 2018 to April 2021 were en⁃rolled and included in an observation group(n=43)and a control group(n=43)according to random number.The control group received patient⁃controlled intravenous analgesia with sufentanil after operation.The observation group received epi⁃dural preemptive analgesia with sufentanil 15 minutes before operation on the basis of the control group.The visual analog scale,Score,VAS score,incidence of adverse reactions,Ramsay sedation score and changes of vital signs were compared be⁃tween the two groups.Results The VAS scores of patients in the observation group at 0h,4h,8h and 12h after operation were lower than those in the control group,with a statistically significant difference(P<0.05).The adverse reaction rate in the observation group was 9.30%,which was lower than that in the control group(27.90%),with a statistically significant difference(P<0.05).Ramsay score of the observation group was higher than that of the control group at each time point af⁃ter operation,with a statistically significant difference(P<0.05);There was no significant difference in SpO_(2),R and PET⁃CO_(2) between the two groups at each time point after operation(P>0.05).Conclusion Preemptive analgesia with intraop⁃erative sufentanil epidural administration+postoperative sufentanil intravenous patient⁃controlled analgesia can effectively improve the sedative and analgesic effects of patients with lower limb fractures and reduce their adverse reaction rate.It is worthy of clinical use.

关 键 词：舒芬太尼 超前镇痛 自控镇痛 下肢骨折 

分 类 号：R614[医药卫生—麻醉学]