|
| 无背景剂量羟考酮静脉自控镇痛联合髋关节囊周神经阻滞用于老年患者全髋关节置换术后镇痛的效果 |
| Effect of patient-controlled intravenous analgesia without background infusion of oxycodone combined with pericapsular nerve group block in elderly patients undergoing total hip arthroplasty |
| |
| DOI：10.12089/jca.2023.05.008 |
| 中文关键词: 背景剂量 羟考酮 神经阻滞 镇痛 髋关节置换术 |
| 英文关键词: Background infusion Oxycodone Nerve block Analgesia Hip arthroplasty |
| 基金项目: |
|
| 摘要点击次数: 729 |
| 全文下载次数: 292 |
| 中文摘要: |
目的 探讨无背景剂量羟考酮静脉自控镇痛联合髋关节囊周神经（PENG）阻滞用于老年患者全髋关节置换术（THA）术后镇痛的效果。
方法 选择择期在蛛网膜下腔阻滞下行单侧THA老年患者99例，男38例，女61例，年龄65～85岁，BMI 18～30 kg/m2，ASA Ⅱ或Ⅲ级。采用随机数字表法将患者分为两组：有背景剂量羟考酮静脉自控镇痛组（P组，n=49）和无背景剂量羟考酮静脉自控镇痛+PENG阻滞组（N组，n=50）。麻醉开始前，N组在髋关节囊周围注射0.375%罗哌卡因20 ml。两组术后均连接静脉自控镇痛，镇痛泵配方：羟考酮40 mg+托烷司琼4 mg用生理盐水稀释至100 ml。P组设置背景剂量2 ml/h，PCA剂量2.5 ml。N组设置为无背景剂量，PCA剂量5 ml。记录术后48 h羟考酮累积消耗量、镇痛泵总按压次数、有效按压次数以及补救镇痛情况，术后4、12、24、48、72 h的静息和活动时VAS疼痛评分，术前1 d、术后1、2、3 d的匹兹堡睡眠质量指数（PSQI）和术后48 h不良反应的发生情况。
结果 与P组比较，N组术后48 h羟考酮累积消耗量以及补救镇痛比例明显降低（P<0.05），总按压次数和有效按压次数明显增加（P<0.05），术后4、12、24 h的静息和活动时VAS疼痛评分明显降低（P<0.05），术后1、2、3 d PSQI评分明显降低（P<0.05），术后恶心、呕吐发生率明显降低（P<0.05）。
结论 无背景剂量羟考酮静脉自控镇痛联合PENG阻滞用于老年患者THA的术后镇痛，镇痛效果满意，可减少术后镇痛药物用量，且能够提高术后睡眠质量，减少术后不良反应的发生。 |
| 英文摘要: |
Objective To evaluate the postoperative analgesia efficacy of patient-controlled intravenous analgesia (PCIA) without background dose of oxycodone combined with pericapsular nerve group (PENG) block in elderly patients undergoing total hip arthroplasty (THA).
Methods Ninety-nine patients, 38 males and 61 females, aged 65-85 years, BMI 18-30 kg/m2, and ASA physical status Ⅱ or Ⅲ, undergoing unilateral total hip arthroplasty under the spinal anesthesia were selected. They were divided into two groups by random number table: PCIA with background dose of oxycodone group (group P, n = 49) and PCIA without background dose of oxycodone + PENG block group (group N, n = 50). Before receiving anesthesia, group N received 0.375% ropivacaine 20 ml around the hip joint pericapsular and both groups connected the PCIA pump after operation. The analgesia pump formula was oxycodone 40 mg + tropisetron 4 mg diluted with saline into 100 ml in both groups. In group P, the background dose was set to 2 ml/h and the PCA dose was 2.5 ml. In group N, no background dose was set and the PCA dose was 5 ml. The total consumption of oxycodone, the number of pressing and remedial analgesia situation during 48 hours after operation, and the VAS pain score at rest and in activity 4, 12, 24, 48, and 72 hours after operation were recorded. The sleep quality and the occurrence of postoperative adverse effects of patients were also recorded.
Results Compared with group P, the consumption of oxycodone and and the number of remedial analgesia in group N 48 hours after surgery were significantly reduced (P < 0.05), the total and effective compressions were significantly increased (P < 0.05), the VAS pain score at rest and in activity 4, 12, and 24 hours after surgery were significantly reduced (P < 0.05), the PSQI score 1, 2, 3 days after surgery were significantly decreased (P < 0.05), and the incidence of postoperative nausea and vomiting were significantly reduced (P < 0.05).
Conclusion PCIA without background dose of oxycodone combined with PENG block for postoperative analgesia in elderly patients undergoing THA shows satisfactory analgesic effects, which reduces the amount of postoperative analgesic drugs, and improves the postoperative sleep quality and decreases the incidence of related adverse effects. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
