羟考酮无背景剂量静脉自控镇痛在老年髋关节置换术后的应用效果  

Application effect of non-background dose of Oxycodone controlled intravenous analgesia in elderly patients after hip replacement

作　　者：王成 王品 WANG Cheng;WANG Pin(Department of Anesthesiology,Nanjing Yi Min Hospital,Jiangsu Province,Nanjing211000,China)

机构地区：[1]南京一民医院麻醉科,江苏南京211000

出　　处：《中国当代医药》2024年第6期86-89,共4页China Modern Medicine

摘　　要：目的探讨羟考酮无背景剂量静脉自控镇痛在老年髋关节置换术后的应用效果。方法选取南京一民医院2021年1月至2022年12月收治的80例择期采用蛛网膜下隙-硬膜外联合麻醉下行髋关节置换术的老年患者作为研究对象,按照随机数字法分为SF组(40例)和Q组(40例),SF组采用舒芬太尼0.5μg/kg配置100 ml的静脉自控镇痛,Q组采用羟考酮0.5 mg/kg配置100 ml的静脉自控镇痛,两组均无背景剂量,镇痛时间均设置48 h。比较两组患者术后2 h(T_(2))、6 h(T_(6))、12 h(T_(12))、24 h(T_(24))、48 h(T_(48))的静脉自控镇痛使用情况,静息和运动时视觉模拟评分法(VAS)评分、谵妄发生率、谵妄持续时间、住院时间及不良反应(皮肤瘙痒、恶心呕吐、低氧血症、心动过缓)发生率。结果两组患者静息及活动时T_(2)、T_(6)、T_(12)、T_(24)、T_(48)VAS评分比较,差异无统计学意义(P>0.05);Q组术后谵妄率(5.0%)低于SF组(22.5%),差异有统计学意义(P<0.05);Q组谵妄的持续时间[(1.89±0.35)h]短于SF组[(2.89±1.58)h],差异有统计学意义(P<0.05);Q组的住院时间[(11.45±2.55)d]短于SF组[(14.78±2.22)d],差异有统计学意义(P<0.05);Q组术后不良反应总发生率低于SF组,差异有统计学意义(P<0.05)。结论羟考酮无背景剂量静脉自控镇痛在老年髋关节置换术后镇痛中有良好的安全性和有效性,可降低术后谵妄的发生。Objective To investigate the effect of non-background dose of Oxycodone controlled intravenous analgesia in elderly patients after hip replacement.Methods A total of 80 elderly patients undergoing joint hip replacement under subarachnoid-epidural anesthesia treated in Nanjing Yi Min Hospital from January 2021 to December 2022 were selected as the study objects.They were divided into SF group(40 cases)and Q group(40 cases)according to random number method.The SF group was given Sufentanil 0.5μg/kg and 100 ml controlled intra venous analgesia,and the Q group was given Oxycodone 0.5 mg/kg and 100 ml controlled intra venous analgesia,and both groups have non-background dose,and the analgesia time were set for 48 h.The use of controlled intra venous analgesia at 2 h(T_(2)),6 h(T_(6)),12 h(T_(12)),24 h(T_(24))and 48 h(T_(48))after surgery,resting and exercise visual analogue scale(VAS)score,incidence of delirium,duration of delirium,length of hospital stay,and incidence of adverse reactions(pruritus,nausea and vomiting,hypoxemia,bradycardia)were compared between the two groups.Results There was no significant difference in T_(2),T_(6),T_(12),T_(24),T_(48)VAS score at resting and exercise between the two groups(P>0.05).The postoperative delirium rate in group Q(5.0%)was lower than that in group SE(22.0%),and the difference was statistically significant(P<0.05).The duration of delirium in Q group([1.89±0.35]h)was shorter than that in SF group([2.89±1.58]h),and the difference was statistically significant(P<0.05).The hospitalization time of Q group([11.45±2.55]d)was shorter than that of SF group([14.78±2.22]d),and the difference was statistically significant(P<0.05).The total adverse reaction rate of Q group was lower than that of SF group,and the difference was statistically significant(P<0.05).Conclusion Non-background dose of Oxycodone intravenous analgesia has a good safety and efficacy in elderly hip arthroplasty analgesia,can reduce the occurrence of postoperative delirium.

关 键 词：羟考酮 无背景剂量 静脉自控镇痛 老年髋关节置换 术后镇痛 谵妄 

分 类 号：R61[医药卫生—外科学]