静脉注射对乙酰氨基酚联合神经阻滞在老年髋部骨折术前镇痛中的应用价值  

Application value of intravenous paracetamol combined with nerve block in preoperative analgesia of elderly patients with hip fracture

作　　者：左艳艳 李云伟 ZUO Yanyan;LI Yunwei(Department of Anesthesiology,Fourth People’s Hospital of Langfang,Langfang 065700,Hebei,China;Department of Emergency Medicine,Fourth People’s Hospital of Langfang,Langfang 065700,Hebei,China)

机构地区：[1]廊坊市第四人民医院麻醉科,河北廊坊065700 [2]廊坊市第四人民医院急诊科,河北廊坊065700

出　　处：《中国现代医生》2025年第7期32-35,共4页China Modern Doctor

基　　金：中关村精准医学基金会临床科研专项资助基金项目(320.2120.2023.1114.17)。

摘　　要：目的评价静脉注射对乙酰氨基酚联合神经阻滞在老年髋部骨折患者术前镇痛中的安全性和有效性。方法选取2023年12月至2024年8月廊坊市第四人民医院收治的老年髋部骨折患者80例,根据随机数字表法将其分为研究组和对照组,每组40例。两组患者均采用髋关节囊周围神经(pericapsular nerve group,PENG)阻滞,在此基础上,研究组给予静脉注射对乙酰氨基酚,对照组给予口服对乙酰氨基酚。比较两组患者的镇痛效果、不良反应和围手术期指标。结果研究组患者的疼痛缓解时间显著短于对照组(P<0.05)。研究组患者的补救镇痛次数、24h内吗啡使用量均显著少于对照组(P<0.05)。两组患者的不良反应发生情况、术前等待时间、住院时间和好转出院患者比例差异均无统计学意义(P>0.05)。结论静脉注射对乙酰氨基酚联合神经阻滞可安全有效地用于老年髋部骨折患者的术前镇痛。Objective To evaluate the safety and efficacy of intravenous paracetamol combined with nerve block in preoperative analgesia in elderly patients with hip fracture.Methods A total of 80 elderly patients with hip fracture admitted to Fourth People’s Hospital of Langfang from December 2023 to August 2024 were selected.According to random number table method,the patients were divided into study group and control group,40 cases in each group.Both groups were blocked by pericapsular nerve group(PENG).Based on this,the study group was given intravenous paracetamol and the control group was given oral paracetamol.The analgesic effect,adverse reactions and perioperative period indexes were compared between two groups.Results The duration of pain relief in study group was significantly shorter than that in control group(P<0.05).The number of analgesia and the amount of morphine used within 24h in study group were significantly lower than those in control group(P<0.05).There were no significant differences in the occurrence of adverse reactions,preoperative waiting time,hospital stay and proportion of patients discharged with improvement between two groups(P>0.05).Conclusion Intravenous paracetamol combined with nerve block can be used safely and effectively for preoperative analgesia in elderly patients with hip fracture.

关 键 词：对乙酰氨基酚 髋部骨折 术前镇痛 神经阻滞 老年 

分 类 号：R683[医药卫生—骨科学] R614.4[医药卫生—外科学]